| NPI | 1033744008 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SULEKO MOHAMED Director 952-400-7878 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2020-03-10 |
| Last Update Date | 2021-07-22 |