| NPI | 1043389117 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHRYN ROBLEY Manager Revenue Cycle 701-239-2286 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2006-11-06 |
| Last Update Date | 2018-03-21 |