| NPI | 1992268726 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACY LEE FILIPI Billing Specialist 218-751-0282 |
| Organization Subpart ? | No |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility |
| Enumeration Date | 2019-04-09 |
| Last Update Date | 2019-04-09 |