| NPI | 1356852180 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA TRYON President 218-428-3448 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MN 1072573) |
| Enumeration Date | 2017-10-19 |
| Last Update Date | 2025-02-10 |