| NPI | 1699170464 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUCAS JAMES NELSON Owner 701-320-4723 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: ND 4336) |
| Enumeration Date | 2014-10-23 |
| Last Update Date | 2015-03-26 |