| NPI | 1982842167 |
|---|---|
| Former Legal Business Name | LAKES AREA YOUTH SERVICE BUREAU |
| Entity Type | Organization |
| Authorized Contact | LINDA M MADSEN Executive Director 651-464-3685 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MN 1179) |
| Additional Taxonomies | 251S00000X (Licence: MN 1946) |
| Enumeration Date | 2009-01-27 |
| Last Update Date | 2020-04-24 |