| NPI | 1699941906 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CYNTHIA ANN SCHACKMAN Familypsychiatricnursepractitioner 218-368-6391 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: MN R 159021-8) |
| Enumeration Date | 2008-05-06 |
| Last Update Date | 2020-04-21 |