| NPI | 1336957273 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | MOHAMED HUSSEN Manager 320-444-9396  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | 
| Enumeration Date | 2024-12-23 | 
| Last Update Date | 2024-12-23 |