| NPI | 1689186587 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATA PETESON Owner/Addiction Counselor 701-640-8915 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2017-10-31 |
| Last Update Date | 2018-06-16 |