| NPI | 1710227103 |
|---|---|
| Doing Business As | PARK AVENUE CENTER MENTAL HEALTH SERVICES |
| Entity Type | Organization |
| Authorized Contact | MARK CASAGRANDE Executive Director 612-871-7443 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist |
| Enumeration Date | 2013-02-21 |
| Last Update Date | 2013-02-21 |