| NPI | 1801418074 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VILMARIE FRAGUADA NARLOCH Board Member 651-338-8231 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2020-05-11 |
| Last Update Date | 2020-05-11 |