| NPI | 1760029722 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIM HAWTHORNE CEO 608-654-5100 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2019-12-09 |
| Last Update Date | 2024-09-13 |