| NPI | 1528326675 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK BJERKE Director 715-834-3171 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 1962-132) |
| Enumeration Date | 2012-04-26 |
| Last Update Date | 2012-04-26 |