| NPI | 1912719337 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMIN MAHAMOUD Manager 651-399-9914 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2025-01-22 |
| Last Update Date | 2025-01-22 |