| NPI | 1720707342 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FARHAN N GULED Owner 612-517-7096 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2022-08-25 |
| Last Update Date | 2022-08-25 |