| NPI | 1366967671 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ABDULAHI HASSAN MOHAMED Owner 952-393-2120 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2017-08-08 |
| Last Update Date | 2022-07-21 |