| NPI | 1184282576 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACEY GUNN Operations Director 715-803-9500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| Enumeration Date | 2019-05-31 |
| Last Update Date | 2019-06-11 |