| NPI | 1407271695 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRETT A KNUTSON President/Co Founder 608-519-5906 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 12863-130) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 16304-130) | |
| 101YM0800X Counselor, Mental Health (Licence: WI 1231-226) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WI 27182) | |
| Enumeration Date | 2014-02-25 |
| Last Update Date | 2024-08-05 |