| NPI | 1942221080 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTIAN TODD ANDERSON CEO 763-416-4167 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TA0400X Psychologist, Addiction (Substance Use Disorder) (Licence: MN LP4615) |
| Additional Taxonomies | 103TC1900X Psychologist, Counseling (Licence: MN LP4615) |
| Enumeration Date | 2006-07-22 |
| Last Update Date | 2020-08-22 |