| NPI | 1295212355 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PETRONELLAH THOKO THOMAS-SHANOBI CEO/Clinical Director 612-408-7733 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 251E00000X Home Health |
| 101YM0800X Counselor, Mental Health | |
| 261QC1500X Clinic/Center, Community Health | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 251S00000X | |
| 261QM1000X Clinic/Center, Migrant Health | |
| 252Y00000X Early Intervention Provider Agency | |
| Enumeration Date | 2018-07-22 |
| Last Update Date | 2023-09-25 |