| NPI | 1811368723 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHERRI M DUNHAM Owner 952-767-4995 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: MN 1431) |
| Enumeration Date | 2015-10-19 |
| Last Update Date | 2015-10-19 |