| NPI | 1093573768 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAITLIN BURKE Owner 763-639-7474 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2024-03-07 |
| Last Update Date | 2024-03-07 |