| NPI | 1710411889 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA PITTON Therapist 952-270-9108 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MN cc01403) |
| Enumeration Date | 2017-04-16 |
| Last Update Date | 2017-04-16 |