| NPI | 1134307689 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOYCE J TERHORST Therapist 763-370-8880 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MN 1486) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: MN 302193) |
| Enumeration Date | 2008-02-07 |
| Last Update Date | 2008-02-07 |