| NPI | 1518697192 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER LENORE ANDERSON Owner 701-353-9979 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| Enumeration Date | 2022-06-15 |
| Last Update Date | 2022-06-15 |