| NPI | 1598129041 |
|---|---|
| Doing Business As | OSHKI MANIDOO |
| Entity Type | Organization |
| Authorized Contact | JEREMY SYVERSON Administrator 218-751-6553 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2016-04-11 |
| Last Update Date | 2016-04-11 |