| NPI | 1194945378 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMEKO HAGEN Director 920-735-9010 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2007-04-27 |
| Last Update Date | 2013-11-18 |