| NPI | 1497264147 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SOMACHANARY KRISTIE KUOCH Owner 952-405-6960 |
| Organization Subpart ? | No |
| Primary Taxonomy | 172V00000X Community Health Worker (Licence: MN 383702) |
| Enumeration Date | 2017-09-26 |
| Last Update Date | 2022-07-21 |