| NPI | 1780398123 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADNA MAXAMED Owner 612-227-7918 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 252Y00000X Early Intervention Provider Agency |
| Enumeration Date | 2023-01-10 |
| Last Update Date | 2025-06-20 |