| NPI | 1326154378 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAMELA JEAN JENKS A.O.D.A. Counsler 262-542-3255 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 684) |
| Enumeration Date | 2006-08-22 |
| Last Update Date | 2008-08-08 |