| NPI | 1073889358 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CATHERINE BUCHEGER Billing Director 262-490-7933 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| Enumeration Date | 2012-03-30 |
| Last Update Date | 2023-02-20 |