| NPI | 1194359547 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AHMEDWELI FARAH Owner/Administrator 952-658-6845 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2020-02-25 |
| Last Update Date | 2024-07-17 |