| NPI | 1659912319 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARMEN PERSAUD Co Executive Director 920-663-1035 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| Enumeration Date | 2019-10-03 |
| Last Update Date | 2025-03-24 |