| NPI | 1932167277 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHELLY ROTERT Accounts Receivable 605-352-8596 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: SD 1) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: SD 2) |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2022-08-09 |