| NPI | 1003409814 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WHITNEY WESSELS Owner 763-328-0606 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2021-02-12 |
| Last Update Date | 2022-01-30 |