| NPI | 1265731012 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW M. PAYMAR Owner 612-293-9332 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MN LPCC cc00275) |
| Enumeration Date | 2011-03-19 |
| Last Update Date | 2011-03-19 |