| NPI | 1841002151 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | SIAD WARSAME Owner 612-607-4494 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health | 
| Enumeration Date | 2025-01-23 | 
| Last Update Date | 2025-01-23 |