| NPI | 1922875400 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARLEY LINN BAGHAI Member 218-839-1033 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2023-12-05 |
| Last Update Date | 2023-12-11 |