| NPI | 1922449057 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RACHAEL TARRAS Director Of Operations 763-432-3926 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MN 1669) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: MN 1111) |
| 251S00000X Community/Behavioral Health (Licence: MN 5007) | |
| Enumeration Date | 2013-07-17 |
| Last Update Date | 2018-04-14 |