| NPI | 1447606959 |
|---|---|
| Former Legal Business Name | FOND DU LAC RESERVATION BUSINESS COMMITTEE |
| Entity Type | Organization |
| Authorized Contact | MARILYN GROVER Associate Director 218-879-1227 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2016-05-13 |
| Last Update Date | 2016-10-10 |