| NPI | 1124105150 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAY W KINNEY Director/Psychotherapist 262-542-3255 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: WI 4034-123) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2020-08-22 |