| NPI | 1285645325 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATE L BOTTIGER Executive Director 952-200-5746 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MN LP3666) |
| Additional Taxonomies | 104100000X Social Worker (Licence: MN 16803) |
| 104100000X Social Worker (Licence: MN 04002) | |
| 251B00000X Case Management | |
| 261QD1600X Clinic/Center, Developmental Disabilities | |
| Enumeration Date | 2006-08-11 |
| Last Update Date | 2019-08-14 |