| NPI | 1023783198 |
|---|---|
| Doing Business As | M HEALTH FAIRVIEW MASONIC INSTITUTE FOR THE DEVELOPING BRAIN CLINIC |
| Entity Type | Organization |
| Authorized Contact | MELISSA LINDBERG VP Revenue Management 612-672-7885 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X |
| Enumeration Date | 2021-08-11 |
| Last Update Date | 2024-05-13 |