| NPI | 1013100171 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMEKO HAGEN Manager 920-735-9010 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: WI 2742) |
| Enumeration Date | 2007-08-22 |
| Last Update Date | 2007-08-22 |