| NPI | 1770132284 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIONNE LYNN SPOONER Owner 701-721-8978 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2019-09-06 |
| Last Update Date | 2019-09-27 |