| NPI | 1316241045 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CASSANDRA LEE Therapist 651-775-5693 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MN 6234569) |
| Enumeration Date | 2011-01-10 |
| Last Update Date | 2011-01-10 |