| NPI | 1487474839 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NASCHAE THOMAS Owner 262-900-4743 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA0600X Clinic/Center, Adult Day Care |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| Enumeration Date | 2024-10-11 |
| Last Update Date | 2024-10-11 |