| NPI | 1932398971 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYLE G ELENKIWICH Mental Health Provider 763-242-9240 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251B00000X Case Management (Licence: MN 11797) |
| Enumeration Date | 2007-10-16 |
| Last Update Date | 2007-10-16 |