| NPI | 1508107541 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELANIE MP VINTON Owner 651-983-3879 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2013-03-14 |
| Last Update Date | 2013-03-14 |