| NPI | 1225776255 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEANNA VIRAMONTES CEO 715-808-2480 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QR0401X Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) |
| Enumeration Date | 2022-05-20 |
| Last Update Date | 2022-05-20 |