| NPI | 1174968580 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK JUERGENS Owner 715-833-2121 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: WI 3265123) |
| Enumeration Date | 2013-04-30 |
| Last Update Date | 2013-04-30 |