| NPI | 1649885716 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SIMON GUBANDJA Owner/ CEO 701-219-5521 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106S00000X Behavior Technician |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2020-09-15 |
| Last Update Date | 2020-09-15 |