| NPI | 1679612337 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TREVOR B JOHNSON Executive Director 612-871-3320 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MN 802463-1-RMI) |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2024-10-07 |