| NPI | 1588410070 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARA MARIE BURKE Owner 763-244-5812 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2024-04-25 |
| Last Update Date | 2024-11-26 |