| NPI | 1942162425 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LENG VANG CEO 763-313-0454 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 261QA0600X Clinic/Center, Adult Day Care |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| Enumeration Date | 2025-12-02 |
| Last Update Date | 2025-12-02 |