| NPI | 1083136352 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AHMEDWELI HASSAN FARAH President/CEO 952-715-7471 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2017-07-08 |
| Last Update Date | 2017-07-08 |