| NPI | 1164148847 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTINE M. GARBACIAK Owner/Clinical Director 920-639-1032 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2022-10-14 |
| Last Update Date | 2022-12-24 |