| NPI | 1902795743 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NASTAHO M ALI Owner 507-530-7077 |
| Organization Subpart ? | No |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2025-06-27 |
| Last Update Date | 2025-06-27 |