| NPI | 1982984845 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTIN JEAN AYDT President 952-808-1400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MN 1228) |
| Enumeration Date | 2011-08-24 |
| Last Update Date | 2015-06-03 |