| NPI | 1235884834 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HEIDI MCNULTY Owner 952-697-9870 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2022-02-14 |
| Last Update Date | 2022-05-20 |