| NPI | 1669047585 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY PATRICIA RODENBERG-ROBERTS VP & Sr Asst Gc 952-836-2234 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD1600X Clinic/Center, Developmental Disabilities |
| Enumeration Date | 2021-05-24 |
| Last Update Date | 2024-01-23 |