| NPI | 1134971880 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYAN NATHANIEL PLASCH Owner 612-207-9953 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2024-04-04 |
| Last Update Date | 2024-04-04 |