| NPI | 1326244609 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH JAMES SIVAK CEO 218-740-3061 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MN 43450) |
| Enumeration Date | 2007-06-25 |
| Last Update Date | 2007-10-05 |