| NPI | 1063112571 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HANAN BAWZER Owner 952-649-0229 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2023-03-06 |
| Last Update Date | 2023-03-06 |