| NPI | 1235707126 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA KUZZY Owner 763-280-4487 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2021-06-16 |
| Last Update Date | 2021-06-16 |