| NPI | 1982579181 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SABRINA SALAZAR Director 651-251-5902 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2025-10-07 |
| Last Update Date | 2025-10-07 |