| NPI | 1033762406 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NANCY JOSEPH-GOLDFARB Authorized Official 612-643-1598 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2019-07-24 |
| Last Update Date | 2019-07-24 |