| NPI | 1750409934 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACKIE J MAURER Office Supervisor 715-349-7069 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: WI 2404) |
| Enumeration Date | 2007-03-27 |
| Last Update Date | 2022-08-19 |