| NPI | 1962126268 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ISMAHAN QALIF Owner 612-310-0448 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2022-09-29 |
| Last Update Date | 2022-09-29 |