| NPI | 1609362888 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACY HANSEN Owner 701-361-8870 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: ND 84261515) |
| Enumeration Date | 2018-07-10 |
| Last Update Date | 2018-07-10 |