| NPI | 1548538275 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACY WEBB Co Director/Member 920-470-1989 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2011-12-08 |
| Last Update Date | 2011-12-08 |