NPI | 1619325164 |
---|---|
Other Name | JOURNEY OF GRACE |
Entity Type | Organization |
Authorized Contact | DEBORAH ANN BONGERS Licensed Professional Counselor 920-750-6120 |
Organization Subpart ? | No |
Primary Taxonomy | 251S00000X (Licence: WI 5970-125) |
Enumeration Date | 2016-05-25 |
Last Update Date | 2016-05-25 |