| NPI | 1093542391 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHLEY GALL Billing Supervisor 701-328-4583 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2024-09-19 |
| Last Update Date | 2024-09-19 |