| NPI | 1932942372 |
|---|---|
| Former Legal Business Name | N/A |
| Entity Type | Organization |
| Authorized Contact | BASHIR ALI Executive Director 651-983-2666 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2024-06-14 |
| Last Update Date | 2025-03-18 |