| NPI | 1326855669 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHONDA STIVERS Owner/Lmac 701-641-0313 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2024-12-11 |
| Last Update Date | 2024-12-18 |