| NPI | 1689297855 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WADE BESEMER President 507-217-6512 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2020-05-22 |
| Last Update Date | 2020-05-22 |