| NPI | 1841650439 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRINA N GIVENS-HENRY Clinical Director 612-916-0945 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2016-02-25 |
| Last Update Date | 2019-10-17 |