| NPI | 1134382815 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY I SULLIVAN Mental Health Services Director 612-362-4449 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: MN 176398) |
| Enumeration Date | 2008-07-03 |
| Last Update Date | 2008-07-03 |