| NPI | 1336982891 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUNETTE CASTILLO Owner 612-445-9353 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center Health Service |
| Additional Taxonomies | 251J00000X Nursing Care |
| 261QC1500X Clinic/Center Community Health | |
| 261QC1800X Clinic/Center Corporate Health | |
| 261QI0500X Clinic/Center Infusion Therapy | |
| 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) | |
| 261QP0905X Clinic/Center Public Health, State or Local | |
| 261QP2300X Clinic/Center Primary Care | |
| 261QP3300X Clinic/Center Pain | |
| 261QU0200X Clinic/Center Urgent Care | |
| 302R00000X Health Maintenance Organization | |
| 332900000X Non-Pharmacy Dispensing Site | |
| Enumeration Date | 2024-06-13 |
| Last Update Date | 2024-06-13 |