| NPI | 1356910475 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY ELAINE SWART Owner 320-238-9119 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2021-06-22 |
| Last Update Date | 2021-08-31 |