| NPI | 1164278107 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MASLAH OSMAN President 612-434-8437 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Additional Taxonomies | 261QM0801X |
| Enumeration Date | 2024-04-29 |
| Last Update Date | 2024-04-29 |