| NPI | 1427114487 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADAM FOX Md 612-374-1021 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: MN 38173) |
| Enumeration Date | 2006-12-27 |
| Last Update Date | 2020-08-22 |