| NPI | 1982816062 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN THEODORE PERRON President 651-674-4884 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320700000X Residential Treatment Facility, Physical Disabilities (Licence: MN 1026041-1-AFC) |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2020-08-22 |