| NPI | 1821697202 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FAHMO MOHAMED President 612-280-6593 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2020-10-18 |
| Last Update Date | 2020-12-01 |