| NPI | 1144388273 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HEIDI LYNN CORDER Program Director 320-763-6261 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MN 443022101) |
| Enumeration Date | 2006-12-04 |
| Last Update Date | 2020-08-22 |