NPI | 1144684697 |
---|---|
Doing Business As | NORTH WEST WISCONSIN COMPREHENSIVE TREATMENT CENTER |
Entity Type | Organization |
Authorized Contact | BRIAN PHILLIP FARLEY VP & Secretary 615-861-6000 |
Organization Subpart ? | Yes |
Primary Taxonomy | 261QM2800X Clinic/Center Methadone |
Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
Enumeration Date | 2016-04-11 |
Last Update Date | 2024-10-25 |