| NPI | 1790017721 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISHONE AKI HUGHES-POLK Director 651-324-0536 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: MN 00024) |
| Additional Taxonomies | 251S00000X (Licence: MN 174706) |
| Enumeration Date | 2010-02-01 |
| Last Update Date | 2010-02-01 |