| NPI | 1467147538 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIFFANY MARIE HOWARD Owner 920-306-2602 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2023-04-05 |
| Last Update Date | 2023-10-25 |