NPI | 1164569679 |
---|---|
Entity Type | Organization |
Authorized Contact | MARY A JOHNSON Chief Operating Officer 612-884-0802 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0850X Clinic/Center Adult Mental Health |
Additional Taxonomies | 261QM0855X Clinic/Center Adolescent and Children Mental Health |
Enumeration Date | 2007-01-31 |
Last Update Date | 2013-02-20 |