| NPI | 1295627826 |
|---|---|
| Doing Business As | ELSEWHERE |
| Entity Type | Organization |
| Authorized Contact | KYLE KELLER Owner 651-307-5148 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2025-07-17 |
| Last Update Date | 2025-07-17 |