| NPI | 1154404325 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS JOHNSON CEO 218-327-2001 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MN 805713-1-CDT) |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2021-08-20 |