| NPI | 1316710585 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHELBY BRANDSMA Sole Member 920-296-0611 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2023-10-31 |
| Last Update Date | 2023-10-31 |