| NPI | 1215695986 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KINSI M MIRREH Owner 612-607-9414 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2021-11-30 |
| Last Update Date | 2021-11-30 |