| NPI | 1184856338 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES VINCENT DAWLEY Director 507-206-4202 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MN LP1394) |
| Enumeration Date | 2009-08-20 |
| Last Update Date | 2009-08-20 |