| NPI | 1720344286 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANICE M LOGAN Exec Director 218-847-8572 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2012-04-09 |
| Last Update Date | 2014-09-22 |