| NPI | 1265802532 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER MCCALLA Owner 651-356-4436 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MN 12610) |
| Enumeration Date | 2015-09-30 |
| Last Update Date | 2015-10-07 |