| NPI | 1710066352 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTIN RENZ-JOHNSON Manager, Revenue Cycle 701-271-1494 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2006-11-03 |
| Last Update Date | 2024-04-03 |