| NPI | 1407048481 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY K DUCHIN Manager 262-646-6280 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: WI 27719) |
| Enumeration Date | 2007-08-14 |
| Last Update Date | 2007-08-14 |