| NPI | 1417034893 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROL M ALLAN Owner 262-789-9171 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) (Licence: WI 1889) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2020-08-22 |