| NPI | 1427367663 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LIZ M LUND Provider Network Manager 715-284-9851 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) (Licence: WI 1413) |
| Enumeration Date | 2010-10-06 |
| Last Update Date | 2018-03-27 |