| NPI | 1083291520 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HOLLY HAKES Owner 715-861-3045 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2021-03-29 |
| Last Update Date | 2021-03-29 |