| NPI | 1386249894 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GORDON T EDWARDS CFO/COO 715-387-5823 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2020-12-02 |
| Last Update Date | 2020-12-02 |