| NPI | 1831921162 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY JANE SHARKEY Owner 952-484-4885 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2024-08-15 |
| Last Update Date | 2024-08-15 |