| NPI | 1124639190 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY G. MATTISON-WYNN CEO 763-478-7395 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2020-08-13 |
| Last Update Date | 2021-04-01 |