| NPI | 1346466562 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES R. LAJEUNESSE Director 608-782-5775 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) (Licence: WI 1151) |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2020-08-22 |