| NPI | 1326657602 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AARON CHAPMAN Controller 701-232-3133 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2020-07-23 |
| Last Update Date | 2021-09-22 |