| NPI | 1902344591 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TONYA MARIE ZIMMERMAN Office Manager 218-999-7750 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2017-02-03 |
| Last Update Date | 2023-03-08 |