| NPI | 1659717502 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAINHIA KHANG Owner 651-212-4877 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2013-05-20 |
| Last Update Date | 2024-06-12 |