| NPI | 1235717521 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANNON ROBINSON VP 608-477-8670 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| 1041C0700X Social Worker, Clinical | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2021-03-30 |
| Last Update Date | 2021-04-29 |