| NPI | 1417023458 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL J CLEVETTE President 218-391-7129 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| 251E00000X Home Health (Licence: MN 06443) | |
| 251S00000X | |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2022-08-25 |