| NPI | 1205034535 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUE M PANGER President 262-652-9599 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2007-07-09 |
| Last Update Date | 2010-09-14 |