| NPI | 1508909730 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELLA MAE GROSS Ex Director 763-566-4251 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MN 831150-3-SILS) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: MN 805936-5-WS) |
| 251S00000X Community/Behavioral Health (Licence: MN 074522700) | |
| Enumeration Date | 2007-02-15 |
| Last Update Date | 2008-10-16 |