| NPI | 1821208612 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARRY N ELLINGSON CEO 218-444-4657 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MN 714818600) |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2011-04-07 |