| NPI | 1235299124 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIE DUNCAN Clinic Manager 651-266-7920 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: MN 830635-1-MHC) |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2018-02-27 |