| NPI | 1154022697 |
|---|---|
| Doing Business As | CLUB FOR BOYS |
| Entity Type | Organization |
| Authorized Contact | DOUGLAS HERRMANN Executive Director 605-343-3500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 172V00000X Community Health Worker |
| Enumeration Date | 2023-03-13 |
| Last Update Date | 2023-03-13 |