| NPI | 1407249477 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AARON W JOHNSON CEO 952-456-7316 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: MN 1251) |
| Enumeration Date | 2015-03-14 |
| Last Update Date | 2024-01-17 |