| NPI | 1407688971 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM H KIRKLAND Owner 651-434-9312 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2024-08-14 |
| Last Update Date | 2024-08-14 |