| NPI | 1063718815 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAMELA PHILLIPS OLSON Owner 608-233-7431 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: WI 2122123) |
| Enumeration Date | 2011-01-26 |
| Last Update Date | 2011-11-29 |