| NPI | 1215512199 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEIGHA SCHOLTZ Clinical Therapist 763-333-8001 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2021-03-12 |
| Last Update Date | 2021-03-12 |