| NPI | 1295226512 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREW TODD BROCKER Facility Director 920-632-2248 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Enumeration Date | 2018-05-22 |
| Last Update Date | 2018-05-22 |