| NPI | 1689125437 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEONNE MARIE WILLIAMS President CEO 218-252-8821 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: MN 19439) |
| Additional Taxonomies | 261QM0801X (Licence: MN 19439) |
| Enumeration Date | 2016-10-17 |
| Last Update Date | 2016-10-17 |