| NPI | 1558644633 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHLEEN KANE Therapist 651-528-8587 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MN 16545) |
| Enumeration Date | 2011-09-24 |
| Last Update Date | 2011-09-24 |