| NPI | 1457718041 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN ZIRNGIBLE Owner 952-892-1200 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MN 2154) |
| Enumeration Date | 2016-01-27 |
| Last Update Date | 2016-01-27 |