| NPI | 1790872562 |
|---|---|
| Other Name | PROFESSIONAL FAMILY BASED DIVISION |
| Entity Type | Organization |
| Authorized Contact | BRIAN A. NYSTROM CEO 651-628-9566 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2016-03-15 |