| NPI | 1457897167 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLAY JOSEPH PAVLIS Owner 605-864-1795 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: MN 47358) |
| Enumeration Date | 2017-01-19 |
| Last Update Date | 2017-01-19 |