| NPI | 1760366298 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MCKENZIE MOOR Owner 701-609-9494 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Additional Taxonomies | 101YP2500X Counselor Professional |
| 164W00000X Licensed Practical Nurse | |
| 235Z00000X Speech-Language Pathologist | |
| 163W00000X Registered Nurse | |
| 225100000X Physical Therapist | |
| 103TP0016X Psychologist Prescribing (Medical) | |
| 1041C0700X Social Worker Clinical | |
| 101YA0400X Counselor Addiction (Substance Use Disorder) | |
| 103TC0700X Psychologist Clinical | |
| 171400000X | |
| 171M00000X Case Manager/Care Coordinator | |
| 363A00000X Physician Assistant | |
| 225X00000X Occupational Therapist | |
| 363LF0000X Nurse Practitioner Family | |
| Enumeration Date | 2025-08-05 |
| Last Update Date | 2025-10-27 |