| NPI | 1093869588 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CYNTHIA RAE THOMAS Clinical Director 920-497-6161 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: WI 2283) |
| Enumeration Date | 2007-01-22 |
| Last Update Date | 2010-03-15 |