| NPI | 1154433605 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHY MUROWSKI Regional Supervisor 262-641-9050 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WI 1058) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 1060) |
| 101YM0800X Counselor, Mental Health (Licence: WI 1060) | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 1058) | |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2010-03-17 |