| NPI | 1497961551 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES W CALLENDER Practice Manager 608-233-2100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI HFS 75.13) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WI HFS 61.91) |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2015-06-15 |