| NPI | 1093542862 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY DWINNELL-DILLON Manager/Owner 218-232-3089 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center Adult Mental Health |
| Additional Taxonomies | 261QM0855X Clinic/Center Adolescent and Children Mental Health |
| Enumeration Date | 2024-09-16 |
| Last Update Date | 2024-09-16 |