| NPI | 1003094731 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES MCCAFFERTY Owner 651-227-6369 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: MN 17268) |
| Enumeration Date | 2008-02-05 |
| Last Update Date | 2008-02-05 |