| NPI | 1003581273 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEX KEITH EATON Licensed Clinical Psychologist 701-839-0474 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2021-08-10 |
| Last Update Date | 2021-08-10 |