| NPI | 1760285134 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHLEEN ELAINE STITELEY Member And Manager 920-445-9723 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2025-03-31 |
| Last Update Date | 2025-06-12 |