| NPI | 1013797877 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ABDULHAMID HASSAN JIBRELL CEO 651-246-1263 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 252Y00000X Early Intervention Provider Agency |
| Enumeration Date | 2023-09-29 |
| Last Update Date | 2023-10-02 |