| NPI | 1548652910 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRYSTLYN MROCZENSKI Collaborative Counselor 920-216-8700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: TX 32450000X) |
| Enumeration Date | 2015-02-23 |
| Last Update Date | 2015-02-23 |