| NPI | 1649934993 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THAO-HA PHAN Partner 612-747-2113 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2021-10-23 |
| Last Update Date | 2024-06-14 |