| NPI | 1477251312 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MORGAN L PHILLIPS Owner 920-713-2922 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2023-02-20 |
| Last Update Date | 2023-02-22 |