| NPI | 1316002694 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LIZ M LUND Provider Network Manager 715-284-9851 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: WI 1413) |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) | |
| Enumeration Date | 2006-12-27 |
| Last Update Date | 2025-09-08 |