| NPI | 1073187860 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARA CHARLIE KELNER Counselor 701-665-3263 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 251S00000X | |
| Enumeration Date | 2021-05-17 |
| Last Update Date | 2021-06-09 |