| NPI | 1043591357 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICK ROCK CEO 612-721-9800 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: MN 6115875) |
| Enumeration Date | 2011-08-31 |
| Last Update Date | 2011-08-31 |