| NPI | 1043038094 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE NICOLE KRYPEL Clinical Social Worker 612-206-2601 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2024-09-30 |
| Last Update Date | 2024-09-30 |