| NPI | 1336443654 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACEY JEAN FREI Office Manager 701-365-4467 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: ND 7174) |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health (Licence: ND 7174) |
| Enumeration Date | 2010-12-29 |
| Last Update Date | 2014-04-30 |