| NPI | 1083460208 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MOHAMED MOHAMUD KHALIF Co Owner 651-428-3783 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD1600X Clinic/Center Developmental Disabilities |
| Enumeration Date | 2024-04-29 |
| Last Update Date | 2024-04-29 |