| NPI | 1992061311 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA CAROL HEITZINGER Chemical Dependency Counselor 612-454-2345 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MN 303284) |
| Enumeration Date | 2012-04-10 |
| Last Update Date | 2012-04-10 |