| NPI | 1013330133 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIDGET LEONARD Owner 651-587-3884 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MN 18865) |
| Enumeration Date | 2014-01-24 |
| Last Update Date | 2014-03-25 |