| NPI | 1598186991 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GRETCHEN TIMMERMAN Administrator 608-393-0707 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: WI 0014785) |
| Enumeration Date | 2014-01-02 |
| Last Update Date | 2014-01-02 |