| NPI | 1649747528 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NIKKI MCKOY Owner 612-889-5899 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 104100000X Social Worker | |
| Enumeration Date | 2018-10-29 |
| Last Update Date | 2018-10-29 |