NPI | 1194572305 |
---|---|
Entity Type | Organization |
Authorized Contact | RACHAEL LOUCKS Co Director 715-255-0263 |
Organization Subpart ? | No |
Primary Taxonomy | 251V00000X Voluntary or Charitable |
Additional Taxonomies | 251S00000X |
Enumeration Date | 2024-05-06 |
Last Update Date | 2024-05-06 |