| NPI | 1356117964 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | KYLE WILLIAM ROSS Director Of Mental Health 612-869-3223  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | 
| Enumeration Date | 2023-11-27 | 
| Last Update Date | 2023-11-27 |