| NPI | 1821725177 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALI J SHIREH Clinical Director 952-649-0229 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2022-08-05 |
| Last Update Date | 2025-01-07 |