| NPI | 1134586647 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE ANN WESTBROCK Owner 701-425-1058 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: ND 58881507194) |
| Enumeration Date | 2016-01-28 |
| Last Update Date | 2016-01-28 |