| NPI | 1124434816 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JILLIAN BAUER Business Supervisor 608-757-5152 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: WI 3030) |
| Enumeration Date | 2014-07-02 |
| Last Update Date | 2025-01-27 |