| NPI | 1356747349 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JODI RAMBERG Sole Proprietor 701-317-5692 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: ND 1235) |
| Additional Taxonomies | 101YP2500X Counselor Professional |
| Enumeration Date | 2014-11-18 |
| Last Update Date | 2014-11-18 |