| NPI | 1609714120 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HERITIER RUDEHA Managing Member 701-404-0393 |
| Organization Subpart ? | No |
| Primary Taxonomy | 172V00000X Community Health Worker |
| Additional Taxonomies | 175T00000X Peer Specialist |
| Enumeration Date | 2026-03-24 |
| Last Update Date | 2026-03-24 |