| NPI | 1033515994 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FANNY MILLER Executive Director 612-824-0415 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MN 1316942824) |
| Enumeration Date | 2014-11-05 |
| Last Update Date | 2022-10-24 |