| NPI | 1447789557 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORENA KAY POPPE Executive Director/Owner 701-204-7870 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2017-06-12 |
| Last Update Date | 2021-07-08 |