| NPI | 1669603189 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYNETTE A RASMUSSON Clinical Supervisor 701-751-1860 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: ND 1201) |
| Enumeration Date | 2009-07-31 |
| Last Update Date | 2009-07-31 |