| NPI | 1144265232 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDA FLIES CAROLE Chief Executive Officer 612-251-4179 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: MN LP2828) |
| Enumeration Date | 2006-06-20 |
| Last Update Date | 2009-01-03 |