| NPI | 1346069093 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HANI A HASSAN Owner 763-353-0763 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2024-10-09 |
| Last Update Date | 2025-11-11 |