| NPI | 1740347764 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KODI KELLER Business Manager 701-947-2147 |
| Organization Subpart ? | No |
| Primary Taxonomy | 315P00000X Intermediate Care Facility, Intellectual Disabilities |
| Enumeration Date | 2007-01-02 |
| Last Update Date | 2008-02-15 |