| NPI | 1609541283 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY PATRICIA RODENBERG-ROBERTS VP & Sr Asst General Counsel 952-836-2234 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD1600X Clinic/Center Developmental Disabilities |
| Additional Taxonomies | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2021-08-16 |
| Last Update Date | 2024-08-25 |