| NPI | 1578918330 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PEGGY SUE WOLNER Clinical Social Worker 651-327-2470 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MN 896) |
| Enumeration Date | 2016-04-29 |
| Last Update Date | 2016-04-29 |