| NPI | 1932309267 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE BRENNY Accredidation 320-253-1909 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MN 104100000X) |
| Enumeration Date | 2007-07-24 |
| Last Update Date | 2007-07-24 |