| NPI | 1134664311 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELIC KOSKI President 218-591-2648 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2016-12-27 |
| Last Update Date | 2023-08-21 |