| NPI | 1912685132 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HABON MOHAMED Owner 952-393-1772 |
| Organization Subpart ? | No |
| Primary Taxonomy | 364SP0808X Clinical Nurse Specialist Psychiatric/Mental Health |
| Enumeration Date | 2023-07-07 |
| Last Update Date | 2023-07-07 |