| NPI | 1093268906 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTINE LOUISE HAYDEN Office Manager 715-530-4495 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MN cc00933) |
| Enumeration Date | 2016-07-27 |
| Last Update Date | 2016-12-22 |