| NPI | 1265673412 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EILEEN G. WARREN Director 262-412-0670 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: WI 2106-132) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: WI 11581-134) |
| Enumeration Date | 2009-03-18 |
| Last Update Date | 2009-03-18 |