| NPI | 1306651146 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DERICK GALLAGHER Board Member 612-306-2830 |
| Organization Subpart ? | No |
| Primary Taxonomy | 177F00000X Lodging |
| Additional Taxonomies | 261QM0850X Clinic/Center Adult Mental Health |
| Enumeration Date | 2025-02-10 |
| Last Update Date | 2025-02-19 |