| NPI | 1619229754 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA A KENNEDY CEO 507-828-1433 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MN LP4330) |
| Enumeration Date | 2012-10-14 |
| Last Update Date | 2012-10-14 |