Organization
YOUTH101
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREA POWELL (OFFICER)
(773) 454-9573
Entity
Organization
Contact information
Practice address
345 CEDAR ST APT 416, SAINT PAUL, MN 55101-1049
(773) 454-9573
Mailing address
345 CEDAR ST APT 416, SAINT PAUL, MN 55101-1049
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
06/19/2026
Last updated
06/19/2026
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