| NPI | 1659611861 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDIE ELLIS Administrator 715-447-5574 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: WI 0013267) |
| Enumeration Date | 2013-02-25 |
| Last Update Date | 2013-02-25 |