| NPI | 1205077427 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAN K FEASTER Director 608-663-0763 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: WI 150-123) |
| Enumeration Date | 2009-03-18 |
| Last Update Date | 2009-03-18 |