| NPI | 1780130757 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN THOMAS-MCGREGOR Owner 612-418-5637 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MN MFT1393) |
| Enumeration Date | 2016-08-30 |
| Last Update Date | 2016-08-30 |