| NPI | 1376813584 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY RAY PERRIN President 612-317-0665 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MN LP 305) |
| Enumeration Date | 2012-01-04 |
| Last Update Date | 2012-01-04 |