| NPI | 1497252530 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHEILA JEAN MARKER Owner 952-500-9502 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: MN 1467) |
| Enumeration Date | 2018-04-06 |
| Last Update Date | 2020-08-29 |