| NPI | 1639354178 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER CARNER Office Manager 320-632-0065 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| Enumeration Date | 2008-01-03 |
| Last Update Date | 2008-01-14 |