| NPI | 1407044886 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | MARK GREGORY PERKINS Director 507-529-1758 | 
| Organization Subpart ? | Yes | 
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MN 10475091CDT) | 
| Enumeration Date | 2007-10-10 | 
| Last Update Date | 2017-01-03 |