| NPI | 1912423500 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDSAY LEIGH BRUCKNER Licensed Clinical Social Worker 605-280-9778 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: SD 3598) |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2017-08-16 |
| Last Update Date | 2023-03-06 |