| NPI | 1073886826 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIZABETH COLLINS Owner 763-354-0508 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MN 1415) |
| Enumeration Date | 2012-02-09 |
| Last Update Date | 2012-02-09 |