| NPI | 1689778912 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENDA LU ALEXANDER MCCORMICK Sr. VP And Chief Financial Officer 612-813-6129 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: MN 331018) |
| Additional Taxonomies | 261QM0801X (Licence: MN 331018) |
| Enumeration Date | 2006-09-08 |
| Last Update Date | 2022-10-31 |