| NPI | 1639051592 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FATIMA WOMACK Authorized Agent 612-453-9143 |
| Organization Subpart ? | No |
| Primary Taxonomy | 385HR2055X Respite Care, Respite Care, Mental Illness, Child |
| Enumeration Date | 2025-07-22 |
| Last Update Date | 2025-07-22 |