| NPI | 1003150004 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL ERRICO President 608-783-0506 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2800X Clinic/Center, Methadone Clinic (Licence: WI 2971) |
| Enumeration Date | 2012-11-15 |
| Last Update Date | 2021-09-24 |