11MN

NPI: 1154601474 · Organization · Active

Primary Specialty

Community/Behavioral Health Agency
Community/Behavioral Health

Practice Location

720 3RD AVE NE
STE 109
MINNEAPOLIS, MN 55413-2300 Map ↗
Phone: 360-237-2616
Fax: 360-237-2616

All Specialties & Licenses

  • Community/Behavioral Health Agency Primary (license: 302775, MN)

NPI Registration

Enumerated: 2011-08-17

Last CMS Update: 2011-08-17