| NPI | 1487918199 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIA RUNYAN Executive Director 218-728-1189 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: MN A660083100) |
| Enumeration Date | 2012-06-27 |
| Last Update Date | 2021-09-24 |