| NPI | 1417941063 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MADALINE G. BARNES CFO 651-735-4841 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2005-09-09 |
| Last Update Date | 2011-08-18 |