| NPI | 1427762665 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TREVOR C FENRICH Executive Director 920-233-0888 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 251V00000X Voluntary or Charitable |
| Enumeration Date | 2023-01-12 |
| Last Update Date | 2023-01-13 |