| NPI | 1538709159 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MEGAN M CULLEN Owner/Director 608-291-4787 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| 261QM0801X | |
| Enumeration Date | 2020-01-11 |
| Last Update Date | 2020-06-24 |