| NPI | 1053204933 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAID HASSAN ABDULATIF Manager 612-388-0017 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2025-05-30 |
| Last Update Date | 2025-05-30 |