| NPI | 1770351694 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUKE SZCZECH Vice President 320-216-0166 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2023-12-20 |
| Last Update Date | 2023-12-20 |