| NPI | 1174662464 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RACHELLE J LAUX President Clinical Director 920-231-2858 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 1723) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WI 1723) |
| Enumeration Date | 2007-02-05 |
| Last Update Date | 2020-08-22 |