| NPI | 1669871620 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSE SOOKOCHOFF Chief Financial Officer 608-348-2331 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR1300X Clinic/Center, Rural Health |
| Enumeration Date | 2014-08-15 |
| Last Update Date | 2021-12-17 |