NPI | 1639384043 |
---|---|
Doing Business As | GREAT RIVER ACT-ST. CLOUD |
Entity Type | Organization |
Authorized Contact | DAVID J. BARAGA Executive Director 320-252-5010 |
Organization Subpart ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MN 800356-1-MHC) |
Enumeration Date | 2007-05-11 |
Last Update Date | 2010-12-16 |