| NPI | 1881046258 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW JAMES ZAMASTIL Owner 952-393-1987 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MN 2007) |
| Enumeration Date | 2016-07-08 |
| Last Update Date | 2016-07-08 |