| NPI | 1639395718 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROL JEAN WESLEY Clinic Director 715-845-4900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) (Licence: WI 2719) |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2012-08-24 |