| NPI | 1144038290 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SULEIMAN M ISSE CEO 612-259-7711 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2024-12-20 |
| Last Update Date | 2024-12-20 |