| NPI | 1619420874 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NGOZI EZIKE-FATORMA Co Owner 612-242-6609 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MN LP 3807) |
| Enumeration Date | 2016-07-25 |
| Last Update Date | 2016-07-25 |