| NPI | 1396541942 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID W PALUCH Registered Agent 920-327-2596 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional |
| Additional Taxonomies | 163WP0808X Registered Nurse Psychiatric/Mental Health |
| Enumeration Date | 2025-02-24 |
| Last Update Date | 2025-02-24 |