| NPI | 1720263338 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANNA W COTHRON Medical Director 715-544-4377 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: WI 37525-020) |
| Enumeration Date | 2008-01-02 |
| Last Update Date | 2008-01-02 |