NPI | 1013619972 |
---|---|
Entity Type | Organization |
Authorized Contact | NIMO ALI, CEO, Clinical Director 612-458-5083 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
Additional Taxonomies | 261Q00000X Clinic/Center |
Enumeration Date | 2023-03-21 |
Last Update Date | 2025-05-22 |