| NPI | 1780014399 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAGN O NYANG CEO 612-636-8926 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: MN cc00670) |
| Enumeration Date | 2013-11-18 |
| Last Update Date | 2013-11-18 |