| NPI | 1316764939 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANNON WEGNER Executive Director 763-482-2339 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2024-09-24 |
| Last Update Date | 2024-09-24 |