| NPI | 1225414956 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN GABRIEL PEREZ Professional Clinical Counselor 701-541-0313 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: ND 666-9-1-10-243) |
| Enumeration Date | 2015-08-04 |
| Last Update Date | 2015-08-04 |