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 |