| NPI | 1073021036 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDSAY MERRITT Credentialing 218-310-8896 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Additional Taxonomies | 1041C0700X Social Worker Clinical |
| 101YA0400X Counselor Addiction (Substance Use Disorder) | |
| 163WP0808X Registered Nurse Psychiatric/Mental Health | |
| 207Q00000X Family Medicine (Licence: MN CNP4335) | |
| 2084P0800X Psychiatry & Neurology Psychiatry | |
| 363LP0808X Nurse Practitioner Psychiatric/Mental Health | |
| Enumeration Date | 2018-01-11 |
| Last Update Date | 2025-09-02 |