| NPI | 1184725277 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEANNETTE L. WELTY Co Director 608-442-1637 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 2629) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: WI 2629) |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2020-08-22 |