| NPI | 1003150947 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBRA PIERSON President 262-951-6969 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: WI 3797-125) |
| Enumeration Date | 2012-11-15 |
| Last Update Date | 2012-11-15 |