NPI | 1598058562 |
---|---|
Entity Type | Organization |
Authorized Contact | MARK WAKEFIELD Development Quality Assurance Offic 608-223-0017 |
Organization Subpart ? | No |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 15641-131) |
Enumeration Date | 2011-05-24 |
Last Update Date | 2011-05-24 |