| NPI | 1932967288 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELAINE WOODS Executive Director 763-213-3373 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0800X Clinic/Center, Recovery Care |
| Additional Taxonomies | 261Q00000X |
| Enumeration Date | 2024-03-11 |
| Last Update Date | 2024-03-11 |