| NPI | 1467419200 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATIE L. OATSVALL Executive Director 262-634-2391 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WI 1339) |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2006-04-26 |
| Last Update Date | 2020-06-26 |