| NPI | 1396553319 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RADWAN O HASSAN Owner 952-200-0064 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2024-12-23 |
| Last Update Date | 2024-12-23 |