| NPI | 1275355950 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TANYA L LEE Owner 763-703-0298 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| 101YM0800X Counselor Mental Health | |
| 101YP2500X Counselor Professional | |
| 251B00000X Case Management | |
| 251S00000X Community/Behavioral Health | |
| 261Q00000X Clinic/Center | |
| 261QM0855X Clinic/Center Adolescent and Children Mental Health | |
| Enumeration Date | 2024-10-24 |
| Last Update Date | 2025-06-12 |