| NPI | 1235567454 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JO ANNE SIMONSON Lead Cd Counselor 952-405-2520 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: MN 301633) |
| Additional Taxonomies | 251S00000X (Licence: MN 15026) |
| Enumeration Date | 2013-10-25 |
| Last Update Date | 2013-10-25 |