| NPI | 1902675747 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GATLUAK TUTDEAL Treatment Director 507-213-0002 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2023-12-21 |
| Last Update Date | 2023-12-21 |