NPI | 1043398316 |
---|---|
Entity Type | Organization |
Authorized Contact | LYNETTE GOULD Office Manager 651-636-0308 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: MN 2207891) |
Enumeration Date | 2006-11-02 |
Last Update Date | 2020-08-22 |