| NPI | 1306532015 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRANDON THOMS Owner 715-604-2209 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| 251B00000X Case Management | |
| 251S00000X Community/Behavioral Health | |
| 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) | |
| 343900000X Non-emergency Medical Transport (VAN) | |
| Enumeration Date | 2023-04-14 |
| Last Update Date | 2023-04-14 |