| NPI | 1710117825 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUFELIA M ADDISON Accounts Receivable Supervisor 952-945-4072 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2009-07-23 |
| Last Update Date | 2009-07-23 |