| NPI | 1053955666 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANE KAYE DUNN Clinical Social Worker 507-820-1545 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2019-11-06 |
| Last Update Date | 2019-12-06 |