| NPI | 1679041339 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANN WATSON Owner 651-431-8103 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2018-11-10 |
| Last Update Date | 2018-11-10 |