| NPI | 1548080229 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | ZACHERY R EICHLER Therapist 612-424-5460  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | 
| Enumeration Date | 2024-10-16 | 
| Last Update Date | 2024-10-16 |