NPI | 1962091173 |
---|---|
Entity Type | Organization |
Authorized Contact | MARY PATRICIA RODENBERG-ROBERTS VP & Sr. Asst General Counsel 952-836-2234 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
Additional Taxonomies | 251S00000X |
Enumeration Date | 2021-01-12 |
Last Update Date | 2024-10-14 |