| NPI | 1407100514 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRUCE NICHOLAS Director 608-441-0204 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: WI 1774) |
| Enumeration Date | 2012-10-29 |
| Last Update Date | 2012-10-29 |