| NPI | 1700622198 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELSEY KITTELSON Owner 701-833-7207 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 251S00000X |
| 385H00000X Respite Care | |
| 385HR2060X Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child | |
| 385HR2065X Respite Care, Respite Care, Physical Disabilities, Child | |
| Enumeration Date | 2024-07-03 |
| Last Update Date | 2024-07-03 |