| NPI | 1487712519 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUDITH A POLLARD Clinic Director 920-907-0097 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: WI 2060) |
| Enumeration Date | 2006-12-04 |
| Last Update Date | 2010-11-29 |