| NPI | 1134171127 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RACHEL M MORAN Clinical Director 952-544-6806 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2026-05-29 |