| NPI | 1144368457 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TREVOR B JOHNSON Executive Director 612-871-3320 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Enumeration Date | 2007-02-01 |
| Last Update Date | 2024-10-07 |