| NPI | 1740651330 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL G. ERRICO President 920-232-2332 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM2800X Clinic/Center, Methadone Clinic (Licence: WI 3089) |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: WI 3089) |
| Enumeration Date | 2015-10-08 |
| Last Update Date | 2021-09-24 |