| NPI | 1942471370 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN G LOFGREN Chief Operations Officer 612-238-2302 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MN 80113422CDT) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: MN 8059762CDT) |
| Enumeration Date | 2008-03-13 |
| Last Update Date | 2008-05-13 |