| NPI | 1972383255 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AYAN M HASSAN Authorized Official 612-644-0026 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2023-10-03 |
| Last Update Date | 2026-03-09 |