| NPI | 1144496688 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IRENE K BURBUL Director/Lmft 651-230-6140 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MN 1292) |
| Enumeration Date | 2008-05-05 |
| Last Update Date | 2008-05-05 |