| NPI | 1811640808 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREA J PETERSON Financial Manager 701-774-8593 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2022-01-31 |
| Last Update Date | 2022-01-31 |