| NPI | 1215657002 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NDAYISHIMIYE RUSHIMISHA Manager 920-378-7176 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2022-08-31 |
| Last Update Date | 2022-08-31 |