| NPI | 1255866984 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANAE SULLIVAN Executive Director 612-860-8141 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MN cc01437) |
| Enumeration Date | 2017-05-01 |
| Last Update Date | 2024-04-29 |