| NPI | 1548666985 |
|---|---|
| Former Legal Business Name | MARK STEGEMAN |
| Entity Type | Organization |
| Authorized Contact | MARK STEGEMAN Owner 651-497-1021 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MN 2524) |
| Enumeration Date | 2014-11-12 |
| Last Update Date | 2024-05-15 |