| NPI | 1487543617 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIC C HARRIS Manager 701-997-9157 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 315P00000X Intermediate Care Facility, Intellectual Disabilities |
| Enumeration Date | 2025-07-01 |
| Last Update Date | 2025-07-01 |