| NPI | 1245314533 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA R CLUTE Executive Officer 701-852-1376 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 251K00000X Public Health or Welfare |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2016-05-17 |