| NPI | 1497019129 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATASHA NOVIK Meneger 612-306-4957 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA0600X Clinic/Center, Adult Day Care |
| Additional Taxonomies | 347C00000X Private Vehicle |
| Enumeration Date | 2012-06-27 |
| Last Update Date | 2012-06-27 |