| NPI | 1548488331 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHLEEN CONLON Co Owner 952-922-1977 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2007-04-24 |
| Last Update Date | 2020-08-22 |