| NPI | 1861706863 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAREN LEE ECKSTROM Clinical Director 952-913-5403 |
| Organization Subpart ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: MN 10192) |
| Enumeration Date | 2010-08-02 |
| Last Update Date | 2011-10-04 |