| NPI | 1215003231 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN RENE BRUST Psychiatric Nurse Practitioner 507-280-0690 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center Adult Mental Health (Licence: MN R 130695-2) |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2020-08-22 |