| NPI | 1215230156 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHY MURAWSKI Regional Supervisor 262-641-9050 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WI 2174) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 2174) |
| Enumeration Date | 2010-12-15 |
| Last Update Date | 2010-12-15 |