| NPI | 1437040581 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EKAN EKONG Medical Director 763-498-4448 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 385H00000X Respite Care |
| Enumeration Date | 2025-07-15 |
| Last Update Date | 2025-07-15 |