| NPI | 1982387866 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHENIKA BORDEAUX-COLLINS Administrator 701-261-2455 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| 251S00000X Community/Behavioral Health | |
| 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2023-08-08 |
| Last Update Date | 2024-01-10 |