| NPI | 1639996804 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRADLY DELONG President/Therapist 612-799-6011 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2024-09-20 |
| Last Update Date | 2024-09-20 |