| NPI | 1639294168 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACKIE J MAURER Business Office Supervisor 715-327-4322 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: WI 560014) |
| Enumeration Date | 2007-03-21 |
| Last Update Date | 2012-03-27 |