| NPI | 1932126794 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURENCE ALAN KIVENS Co Director 612-822-8227 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2020-08-22 |