| NPI | 1356576979 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANA LESLIE KODADEK Patient Service Representative 701-941-8055 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: ND 1056) |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2009-05-27 |
| Last Update Date | 2024-06-12 |