| NPI | 1972057560 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOMINIC YIEMOH HARRIS Mental Health Professional 320-237-5626 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2016-08-11 |
| Last Update Date | 2016-08-11 |