| NPI | 1881436483 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AYANTU SHANKULIE Owner 651-421-5221 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2024-06-12 |
| Last Update Date | 2024-06-12 |