| NPI | 1316505803 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DARYN ROGERS Owner 952-209-9200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2019-05-30 |
| Last Update Date | 2025-10-30 |