| NPI | 1265128979 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GERARD BALAN CEO/Owner 612-810-6414 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Enumeration Date | 2023-04-14 |
| Last Update Date | 2023-12-20 |