| NPI | 1902656267 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARTHA TAYE Executive Director 651-374-4576 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2024-03-26 |
| Last Update Date | 2024-04-08 |