| NPI | 1184401762 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANN EIDEN VP Of Corporate Services 651-379-1750 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2023-09-08 |
| Last Update Date | 2023-09-08 |