| NPI | 1003411745 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GILBERT JOHNSON Analyst 605-965-3149 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 1041C0700X Social Worker, Clinical | |
| 106H00000X Marriage & Family Therapist | |
| Enumeration Date | 2020-12-01 |
| Last Update Date | 2024-08-14 |