| NPI | 1336694405 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEAH HANSON Owner 701-500-7599 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: ND R29510) |
| Enumeration Date | 2016-08-18 |
| Last Update Date | 2016-08-18 |