| NPI | 1902183338 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL ANTHONY KUSTERMANN CEO 612-767-6601 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MN 1061726) |
| Enumeration Date | 2011-11-14 |
| Last Update Date | 2011-11-14 |