| NPI | 1336443225 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIRIAM ELAINE TELL Pmhnp 218-766-5344 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: MN R127204-4) |
| Additional Taxonomies | 273R00000X Psychiatric Unit (Licence: MN R1272044) |
| Enumeration Date | 2011-01-06 |
| Last Update Date | 2013-12-17 |