| NPI | 1710536081 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FAISEL ELMI President 612-501-8208 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center Adolescent and Children Mental Health |
| Enumeration Date | 2019-09-09 |
| Last Update Date | 2022-10-25 |