| NPI | 1598695645 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN LYONGA CEO 612-810-6309 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TM1800X Psychologist, Intellectual & Developmental Disabilities |
| Enumeration Date | 2026-05-20 |
| Last Update Date | 2026-05-20 |