NPI | 1619314614 |
---|---|
Entity Type | Organization |
Authorized Contact | COLE BUCHTEL Clinical Supervisor 612-462-3310 |
Organization Subpart ? | No |
Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MN 167129) |
Enumeration Date | 2013-05-30 |
Last Update Date | 2013-05-30 |