| NPI | 1427293851 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NANCY DUFFEY BLACK Clinical Director 952-470-6182 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251B00000X Case Management (Licence: MN 6510) |
| Enumeration Date | 2008-12-15 |
| Last Update Date | 2008-12-15 |