| NPI | 1447466065 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTI H KOVACS Owner 920-405-9701 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: WI 2394) |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2020-08-22 |