| NPI | 1881359065 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ABDULLAHI RAGE Ce0 612-407-8681 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2021-11-03 |
| Last Update Date | 2024-12-14 |