| NPI | 1023511714 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RENEE E CARLSON Owner, Mental Health Counselor 952-220-9283 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2018-03-09 |
| Last Update Date | 2018-03-09 |