| NPI | 1952951741 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL AARON WADE Operations Officer 651-431-1168 |
| Organization Subpart ? | No |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency |
| Enumeration Date | 2019-09-13 |
| Last Update Date | 2019-09-13 |