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 |