| NPI | 1215912951 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYNNE OSWALD Owner 715-342-0290 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: WI 2566) |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: WI 2566) |
| Enumeration Date | 2005-12-14 |
| Last Update Date | 2025-09-11 |