| NPI | 1679918833 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JO A. NELSON Executive Director 651-222-0757 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MN 2186) |
| Enumeration Date | 2013-05-01 |
| Last Update Date | 2020-05-26 |