| NPI | 1346139425 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIELLE EBBEN Sole Member 262-393-1664 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2025-07-02 |
| Last Update Date | 2025-11-04 |