| NPI | 1053569798 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | BILLY ANDERSON Founder/Mental Health Clinican 320-259-7706  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MN 12688)  | 
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MN 300215)  | 
| Enumeration Date | 2008-09-07 | 
| Last Update Date | 2022-06-17 |