| NPI | 1285759035 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK ELLIOT Program Director 715-327-4402 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: WI 1004165) |
| Enumeration Date | 2007-03-20 |
| Last Update Date | 2020-08-22 |