| NPI | 1962899013 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SIRRI ATANG NOMO-ONGOLO Administration 612-788-2273 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2015-04-16 |
| Last Update Date | 2015-04-16 |