| NPI | 1114312048 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RENEE SEGAL Owner 612-875-6416 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: MN 2108) |
| Enumeration Date | 2015-03-28 |
| Last Update Date | 2021-11-29 |