| NPI | 1437735073 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COLLEEN PATRICIA HAVLIN BETHEL Owner 612-562-7988 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2021-03-23 |
| Last Update Date | 2022-05-09 |