| NPI | 1275683492 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAM TUCKER Business Manager 612-843-5580 |
| Organization Subpart ? | No |
| Primary Taxonomy | 385HR2055X Respite Care, Respite Care, Mental Illness, Child (Licence: MN 383108753) |
| Enumeration Date | 2007-01-11 |
| Last Update Date | 2017-03-28 |