| NPI | 1063394914 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | LEAH JO LORENTZEN Psychotherapist 612-548-4459  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | 
| Enumeration Date | 2025-07-22 | 
| Last Update Date | 2025-07-22 |