| NPI | 1588871719 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES SAMUEL GUERRERO Owner 952-842-0882 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MN 19891) |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2020-08-22 |