| NPI | 1649281676 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JILL R LEBLOND Hipaa Officer 651-287-0931 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2006-08-11 |
| Last Update Date | 2008-11-21 |