| NPI | 1518498047 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADEYEMI OLUDARE FATOKI Medical Director/Partner 920-770-5061 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2017-03-26 |
| Last Update Date | 2019-12-19 |