| NPI | 1033062476 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA PETERKA Licensed Clinical Social Worker 920-713-3022 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2026-02-17 |
| Last Update Date | 2026-04-22 |