| NPI | 1720222334 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHY M FETSCH Director 715-392-9300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MN 1052968) |
| Enumeration Date | 2009-04-27 |
| Last Update Date | 2016-04-12 |