NPI | 1073703997 |
---|---|
Entity Type | Organization |
Authorized Contact | KEVIN CARL RANDALL Clinical Director/Owner 608-274-8294 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
Enumeration Date | 2007-07-26 |
Last Update Date | 2010-06-16 |