| NPI | 1790545739 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK LONDON DUNHAM Owner 612-685-4982 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 251B00000X Case Management | |
| 251E00000X Home Health | |
| 251K00000X Public Health or Welfare | |
| 253Z00000X In Home Supportive Care | |
| 261QC1500X Clinic/Center, Community Health | |
| 261QC1800X Clinic/Center, Corporate Health | |
| 261QH0100X Clinic/Center, Health Services | |
| Enumeration Date | 2024-03-19 |
| Last Update Date | 2024-03-26 |