| NPI | 1952143745 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAMIR STEVAN UTRZAN Chief Compliance Officer 612-900-7021 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2024-06-11 |
| Last Update Date | 2024-09-09 |