| NPI | 1568824894 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTINE ANN RADLOFF Provider 507-474-4041 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MN 00403) |
| Enumeration Date | 2016-03-25 |
| Last Update Date | 2022-10-18 |