| NPI | 1134352230 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAULA LOUISE DESANTO Owner 612-296-0317 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MN 1054915) |
| Enumeration Date | 2009-08-24 |
| Last Update Date | 2009-08-24 |