| NPI | 1487145546 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRAVADA GARRETT-AKINSANYA Clinical Director 763-522-0100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2018-05-24 |
| Last Update Date | 2018-05-24 |