| NPI | 1104098672 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CYNTHIA E BOUDREAUX Health Services Manager 218-281-5832 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251K00000X Public Health or Welfare (Licence: MN R137745-7) |
| Enumeration Date | 2008-03-25 |
| Last Update Date | 2008-03-25 |