| NPI | 1811328511 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTA L SUERKEN Owner 763-843-5548 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MN LP4709) |
| Enumeration Date | 2013-12-05 |
| Last Update Date | 2013-12-05 |