| NPI | 1013738459 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRIZER A SMITH Executive Director 612-227-7170 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 1041C0700X Social Worker, Clinical | |
| 252Y00000X Early Intervention Provider Agency | |
| Enumeration Date | 2024-10-18 |
| Last Update Date | 2024-10-18 |