| NPI | 1891123956 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANE MICHAEL LARSON President 605-520-0157 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: SD LPC-MH2210) |
| Enumeration Date | 2013-10-28 |
| Last Update Date | 2013-10-28 |