| NPI | 1194749226 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONA L MATHEWS Owner 651-645-7971 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2020-08-22 |