| NPI | 1427172766 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRETT IAN COHEN COO 800-388-5150 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MN Certification only) |
| Enumeration Date | 2007-03-19 |
| Last Update Date | 2023-03-04 |