| NPI | 1740720754 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAREN LOUISE STAIGE Co Owner 507-216-5151 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MN 304332) |
| Enumeration Date | 2017-02-24 |
| Last Update Date | 2019-10-30 |