| NPI | 1326829987 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARAH STOUT Admin 605-858-4524 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2023-10-10 |
| Last Update Date | 2023-10-10 |