| NPI | 1780690420 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN A NYSTROM President/CEO 651-628-4993 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2020-08-22 |