| NPI | 1891819686 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANET MARIE ANDERSON President 612-598-1414 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: MN 15441) |
| Enumeration Date | 2007-03-18 |
| Last Update Date | 2020-03-23 |