| NPI | 1033127444 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NEIL C. VANROSSUM Director 715-526-5466 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: WI 1895) |
| 101Y00000X Counselor (Licence: WI 1896) | |
| 101Y00000X Counselor (Licence: WI 1894) | |
| 103T00000X Psychologist (Licence: WI 1802057) | |
| Enumeration Date | 2006-08-03 |
| Last Update Date | 2009-09-01 |