| NPI | 1396959425 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAREN HOLTON Director Of Accounting 920-206-4458 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2007-05-09 |
| Last Update Date | 2010-11-24 |