| NPI | 1295213759 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHLEEN MATTHEWS Owner 612-978-3209 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2018-08-06 |
| Last Update Date | 2018-08-06 |