| NPI | 1497511182 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HUSSEIN HASSAN Director 612-913-6133 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2024-02-21 |
| Last Update Date | 2024-02-21 |