| NPI | 1720846215 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEAH CLAUSEN Director Of Operations, Owner 763-226-6006 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 1041C0700X Social Worker, Clinical | |
| 106H00000X Marriage & Family Therapist | |
| 133N00000X Nutritionist | |
| 156F00000X Technician/Technologist | |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| 363AM0700X Physician Assistant, Medical | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2024-03-08 |
| Last Update Date | 2024-03-08 |