| NPI | 1265951529 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAMELA RUTH ROSCH Owner 612-251-7998 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: MN LP0260) |
| Enumeration Date | 2017-09-18 |
| Last Update Date | 2022-07-21 |