| NPI | 1316117542 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIM EISSINGER CEO 701-252-3850 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 261QD1600X Clinic/Center, Developmental Disabilities (Licence: ND 85522) |
| Enumeration Date | 2008-03-04 |
| Last Update Date | 2021-02-18 |