| NPI | 1427242205 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANICE DIETERLEN SEGAL Office Manager / Vice President 651-278-4003 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2007-09-05 |
| Last Update Date | 2024-05-07 |