| NPI | 1720359961 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAREN HOLTON Director Of Accounting Services 920-206-4458 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2012-01-19 |
| Last Update Date | 2012-01-19 |