| NPI | 1639402902 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COLLEEN SUZANNA JAMES Director 608-477-9858 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 133) |
| 101YP2500X Counselor, Professional (Licence: WI #2) | |
| 1041C0700X Social Worker, Clinical (Licence: WI #123) | |
| Enumeration Date | 2009-09-17 |
| Last Update Date | 2023-01-09 |