| NPI | 1063194249 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OCTOBER ALLEN Owner & CEO 218-341-7699 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2023-08-07 |
| Last Update Date | 2024-10-20 |