NPI | 1114637667 |
---|---|
Entity Type | Organization |
Authorized Contact | CAMERON D BROWN Owner/CEO 920-252-9024 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
175T00000X Peer Specialist | |
261QR0401X Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) | |
324500000X Substance Abuse Rehabilitation Facility | |
363LF0000X Nurse Practitioner, Family | |
Enumeration Date | 2022-11-23 |
Last Update Date | 2024-08-13 |