| NPI | 1073110383 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORY BETH HELLMAN Member 701-712-5802 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2020-10-08 |
| Last Update Date | 2023-06-09 |