NPI | 1972279230 |
---|---|
Entity Type | Organization |
Authorized Contact | AHMED JAMA Owner 651-329-0402 |
Organization Subpart ? | No |
Primary Taxonomy | 251S00000X |
Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
Enumeration Date | 2021-08-17 |
Last Update Date | 2024-08-01 |