| NPI | 1679014179 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA WINKLER Quality Assurance Director 218-625-2638 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MN cc01473) |
| Enumeration Date | 2017-03-16 |
| Last Update Date | 2021-05-12 |