| NPI | 1689427775 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELLIESHA HAHN Owner 612-963-4242 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2024-04-09 |
| Last Update Date | 2024-04-09 |