| NPI | 1740880764 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAMELA LYNN GRABER Owner/CEO 612-590-4440 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2020-10-28 |
| Last Update Date | 2022-07-21 |