| NPI | 1316147135 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BEVERLY BUCKNER Owner/Director 952-303-3104 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: MN 187930800) |
| Enumeration Date | 2007-07-19 |
| Last Update Date | 2007-07-19 |