| NPI | 1942310974 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAINE QIAO JORENTO Executive Director 651-815-5145 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: MN Certified Day Tx) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2020-08-22 |