| NPI | 1457718439 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MUKTAR S YUSUF President 612-800-4888 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MN 866661400039) |
| Enumeration Date | 2016-01-21 |
| Last Update Date | 2016-01-21 |