| NPI | 1316297492 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS S BOLAN Director 608-751-1042 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2012-09-15 |
| Last Update Date | 2012-10-08 |