| NPI | 1851053698 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHUKRI BASHIR Co Executive Director 651-497-6593 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2021-10-08 |
| Last Update Date | 2021-10-08 |