| NPI | 1790377448 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE PEYERL Director Operations/Auth Official 701-238-3206 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center Health Service |
| Enumeration Date | 2021-02-04 |
| Last Update Date | 2024-01-22 |