| NPI | 1114311685 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA ADELE SHUSTER Clinical Therapist 701-330-9997 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: ND 3839) |
| Enumeration Date | 2015-03-23 |
| Last Update Date | 2015-03-23 |