| NPI | 1205225448 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TROY ROBERT WEBER-BROWN Owner 320-257-6022 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2015-01-12 |
| Last Update Date | 2015-01-12 |