| NPI | 1164576203 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEE CHANG Clinial Therapist 507-990-3225 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2008-05-15 |