| NPI | 1033349436 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FRANK MCCONNELL Administrator 920-339-9307 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: WI 2811) |
| Enumeration Date | 2009-07-20 |
| Last Update Date | 2012-01-27 |