| NPI | 1972099240 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA MARIE ASPER Director Of Contracting, Credential 612-454-2046 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: MN 1089815-3-SUDX) |
| Enumeration Date | 2018-07-10 |
| Last Update Date | 2018-07-10 |