| NPI | 1578145017 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYNDSIE STANDERWICK Owner 612-361-2247 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2021-04-23 |
| Last Update Date | 2021-04-23 |