| NPI | 1477821973 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRI BUSCHER Office Mgr/Owner 218-444-5155 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MN 1051960-1-CDT) |
| Enumeration Date | 2011-12-12 |
| Last Update Date | 2011-12-12 |