| NPI | 1528837580 |
|---|---|
| Other Name | PRIVATE |
| Entity Type | Organization |
| Authorized Contact | DAN WOLFF Authorized Official 920-229-9978 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2024-01-01 |
| Last Update Date | 2024-01-01 |