| NPI | 1902228794 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATHEW QUASCHNICK Counselor 952-210-3266 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MN 636) |
| Enumeration Date | 2014-01-13 |
| Last Update Date | 2014-01-17 |