| NPI | 1811738115 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YASIR ALI HASSAN Owner 952-217-7517 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center Adult Mental Health |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| 261QH0100X Clinic/Center Health Service | |
| 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2024-06-03 |
| Last Update Date | 2024-06-03 |