NPI | 1902302722 |
---|---|
Entity Type | Organization |
Authorized Contact | KENNETH LONGFELLOW HANNA Owner 320-420-1272 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: MN 2571659) |
Enumeration Date | 2018-04-02 |
Last Update Date | 2018-04-02 |