| NPI | 1821241761 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RESMAA MENAKEM Owner 612-810-2605 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MN 15000) |
| Enumeration Date | 2008-10-23 |
| Last Update Date | 2008-10-23 |