| NPI | 1285087924 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAYLA ROWELL Owner 920-632-2248 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2016-07-18 |
| Last Update Date | 2016-07-18 |