| NPI | 1336628478 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA ADELL WIRTH CEO 612-799-6652 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: MN 3061) |
| Enumeration Date | 2018-08-09 |
| Last Update Date | 2021-11-17 |