| NPI | 1891509766 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAYLEE BOND Owner 612-460-1901 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2025-02-03 |
| Last Update Date | 2025-02-03 |