| NPI | 1205932233 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN H. WIEGLENDA Lac 701-483-0795 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: ND 1071) |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: ND 1071) |
| Enumeration Date | 2006-09-16 |
| Last Update Date | 2020-12-10 |