| NPI | 1619133063 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOYCE ANN COLEMAN Executive Director 612-522-4085 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MN 301903) |
| Enumeration Date | 2008-08-05 |
| Last Update Date | 2008-08-05 |