| NPI | 1184877359 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRI L BUSCHER Business Manager 218-444-5155 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MN 1051960) |
| Enumeration Date | 2008-10-31 |
| Last Update Date | 2008-10-31 |