| NPI | 1912283334 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ARLAND P FANNING Treatment Director 612-414-4814 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0401X Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) |
| Enumeration Date | 2011-10-31 |
| Last Update Date | 2011-10-31 |