NPI | 1295157592 |
---|---|
Entity Type | Organization |
Authorized Contact | JILL CHRISTINA KRUSH Sole Proprietor 605-430-0954 |
Organization Subpart ? | No |
Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: CO 11757) |
Enumeration Date | 2014-01-06 |
Last Update Date | 2014-01-06 |