| NPI | 1043588254 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY A KUNZ Director 262-338-8611 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 16431 - 130) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: WI 16431 - 130) |
| Enumeration Date | 2011-12-02 |
| Last Update Date | 2021-01-21 |