| NPI | 1609746809 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRITTANY ICZKOWSKI Owner 715-204-9840 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2025-11-11 |
| Last Update Date | 2025-11-29 |