| NPI | 1831607423 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTI RUTH STOLL General Manager 218-346-2322 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 252Y00000X Early Intervention Provider Agency |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2018-01-17 |
| Last Update Date | 2020-04-07 |