| NPI | 1740669498 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHUKWUEMEKA ALEXANDER ANYAKE Physician 612-806-3011 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care (Licence: MN 52657) |
| Additional Taxonomies | 261QH0100X Clinic/Center Health Service (Licence: MN 52657) |
| 261QM0850X Clinic/Center Adult Mental Health (Licence: MN 53530) | |
| 305S00000X Point of Service (Licence: MN 52657) | |
| Enumeration Date | 2015-05-27 |
| Last Update Date | 2015-05-27 |