| NPI | 1619352226 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SOBIA KIRMANI-MOE Owner 608-713-9898 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: WI 57589-20) |
| Enumeration Date | 2015-07-24 |
| Last Update Date | 2025-03-29 |