| NPI | 1629437793 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | INEZ BERSIE-MIZE Owner 651-249-9749 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MN 1106) |
| Enumeration Date | 2016-02-18 |
| Last Update Date | 2016-02-18 |