| NPI | 1073647665 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRIS CHOUINARD Finance Manager 715-235-4537 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: WI 1050) |
| Enumeration Date | 2007-03-15 |
| Last Update Date | 2021-03-02 |