| NPI | 1811129430 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYAN FOUTS Executive Director 612-254-7656 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2009-08-15 |
| Last Update Date | 2021-12-01 |