| NPI | 1790594000 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HASHIM AIDEED CEO 952-228-5906 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center Adolescent and Children Mental Health |
| Additional Taxonomies | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2025-01-01 |
| Last Update Date | 2025-01-01 |