| NPI | 1033785332 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KASANDRA MILLER Accountant/Billing Specialist 715-799-3861 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2021-05-28 |
| Last Update Date | 2021-05-28 |