| NPI | 1275817553 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHRINE LINN BRATHEN Owner 651-303-4734 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MN LP5212) |
| Enumeration Date | 2011-10-04 |
| Last Update Date | 2011-10-04 |