| NPI | 1144260589 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEAN ANN JOHNSON Administrator/Owner 651-488-4655 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251E00000X Home Health (Licence: MN 329047) |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2020-05-05 |