| NPI | 1598700528 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOMINICA TALLARICO COO 612-222-2222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 103T00000X Psychologist |
| 2084P0800X Psychiatry & Neurology Psychiatry | |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2025-02-24 |