| NPI | 1538684121 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUCINDA THIMM-JURADO Owner 608-833-9770 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WI 2414-12) |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| Enumeration Date | 2017-08-04 |
| Last Update Date | 2017-08-04 |