| NPI | 1528733649 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HEATHER LYNN MACH Therapis 651-815-9405 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 261QM0801X |
| Enumeration Date | 2021-08-11 |
| Last Update Date | 2021-08-11 |