| NPI | 1497541247 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARCIA ALEXANDER Clinical Social Worker 612-298-2355 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2025-04-17 |
| Last Update Date | 2025-07-16 |