| NPI | 1609048883 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK THOMAS MEYER CFO 651-631-6120 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: MN 338275) |
| Enumeration Date | 2008-03-28 |
| Last Update Date | 2017-11-16 |