| NPI | 1508465147 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HEATHER FRACH Owner 218-888-7980 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2020-10-24 |
| Last Update Date | 2022-04-08 |