| NPI | 1184367146 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MOHAMUD AHMED CEO 507-517-9142 |
| Organization Subpart ? | No |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency |
| Additional Taxonomies | 251S00000X |
| 261Q00000X Clinic/Center | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2022-04-18 |
| Last Update Date | 2024-07-25 |