| NPI | 1124145370 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICK KALAMBOKISIS CFO 715-327-4402 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: WI 2195) |
| Enumeration Date | 2007-03-23 |
| Last Update Date | 2010-09-23 |