| NPI | 1124372586 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORA HUDSON Office Manager 608-241-4285 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: WI 2986) |
| Enumeration Date | 2012-11-06 |
| Last Update Date | 2019-12-16 |