| NPI | 1639926819 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ABDIAZIZ JAMA Manager 612-227-4094 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2024-05-04 |
| Last Update Date | 2024-05-07 |