| NPI | 1316395189 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA M. GOETZ Owner 701-751-8060 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2016-06-01 |
| Last Update Date | 2020-07-06 |