| NPI | 1932475647 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUANN K. HANSON Director/Co Owner 612-205-5332 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MN 4215392-2) |
| Enumeration Date | 2012-03-27 |
| Last Update Date | 2026-03-17 |