| NPI | 1922860782 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRIZER SMITH Owner 612-382-8783 |
| Organization Subpart ? | No |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 103K00000X Behavior Analyst | |
| 1041C0700X Social Worker, Clinical | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2024-01-26 |
| Last Update Date | 2024-01-26 |