| NPI | 1235887860 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MACK ELLIS MONTGOMERY Owner 701-441-1552 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251B00000X Case Management |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2022-03-14 |
| Last Update Date | 2023-03-29 |