| NPI | 1659967537 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALISON L RUSK WIEGMAN Owner 320-429-8554 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2020-12-15 |
| Last Update Date | 2024-05-15 |