| NPI | 1518768910 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAULA CONDOL Director 701-202-7073 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2025-03-21 |
| Last Update Date | 2025-03-21 |