| NPI | 1700359874 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | INTISAR OMAR HUSSEIN President 612-412-3318 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 252Y00000X Early Intervention Provider Agency |
| Enumeration Date | 2019-01-10 |
| Last Update Date | 2025-05-03 |