| NPI | 1447736780 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MEGAN M BUSCH Lac/Lpcc 701-645-1032 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) (Licence: ND 691-7-1-11-232) |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility (Licence: ND 1656) |
| Enumeration Date | 2018-07-18 |
| Last Update Date | 2019-05-22 |