| NPI | 1437298668 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEORGE HENDRICKSON Executive Director 763-350-9236 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MN 801978-7-CPA) |
| Enumeration Date | 2007-02-05 |
| Last Update Date | 2018-10-24 |