| NPI | 1013572056 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ABDISALLAM AHMED ABDULLE Exective Director 612-200-9466 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD1600X Clinic/Center Developmental Disabilities |
| Enumeration Date | 2019-05-06 |
| Last Update Date | 2019-05-06 |