| NPI | 1174395453 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE LAINHART Executive Director 612-384-1007 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0400X Clinic/Center, Rehabilitation |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, |
| 1041C0700X Social Worker, Clinical | |
| Enumeration Date | 2023-10-30 |
| Last Update Date | 2023-10-30 |