| NPI | 1245840735 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHLEY KALINA Owner 651-341-0581 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2020-08-09 |
| Last Update Date | 2021-02-03 |