| NPI | 1215056080 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GENE F BRAAKSMA President, Owner 262-338-1900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: WI 1236 057) |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2007-10-04 |