| NPI | 1275976391 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN R ABLER Contracting/Credentialing 612-237-4380 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MN 989-6811) |
| Enumeration Date | 2013-04-08 |
| Last Update Date | 2014-04-08 |