| NPI | 1053538843 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIM LEVENHAGEN Owner 262-513-0700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WI 33398) |
| Enumeration Date | 2007-04-20 |
| Last Update Date | 2020-08-22 |