| NPI | 1376948810 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIN PACYGA Operations Manager 952-835-2002 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MN cc00849) |
| Enumeration Date | 2014-10-27 |
| Last Update Date | 2014-10-27 |