| NPI | 1457218216 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLIE RAY HYSTAD-MOE Mental Health Therapist 701-570-4027 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2026-01-05 |
| Last Update Date | 2026-01-05 |