| NPI | 1750301040 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THEODORE EDWARD LOBBY President 952-922-0192 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: MN 1145) |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2008-06-13 |