| NPI | 1558635128 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADAM GARCIA Owner 651-385-0600 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MN 1061701-1CDT) |
| Enumeration Date | 2012-02-29 |
| Last Update Date | 2012-02-29 |