| NPI | 1760103626 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADDY NELSON Ladc, Lpcc, Lbsw 701-936-1190 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 104100000X Social Worker |
| Enumeration Date | 2022-09-08 |
| Last Update Date | 2023-07-11 |