| NPI | 1508574328 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEGRA FOWLER Owner 715-280-8130 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2022-11-10 |
| Last Update Date | 2022-12-20 |