| NPI | 1861893547 |
|---|---|
| Doing Business As | EAGLE VISTA RANCH |
| Entity Type | Organization |
| Authorized Contact | ELIZABETH ANNE LETSON Owner/Founder And Lpc 218-760-0656 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: MN 01258) |
| Enumeration Date | 2014-09-11 |
| Last Update Date | 2014-09-11 |