| NPI | 1033583398 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BARBARA MARIE SHOUP ANDERSON Owner 605-222-0997 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: SD 98111026) |
| Enumeration Date | 2015-11-23 |
| Last Update Date | 2015-11-23 |