| NPI | 1386768703 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRETT IAN COHEN COO 800-388-5150 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MN certification only) |
| Enumeration Date | 2007-03-19 |
| Last Update Date | 2023-03-05 |