| NPI | 1770757924 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RENEE M MILLWOOD Director 715-634-0607 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: WI 42221700) |
| Enumeration Date | 2008-04-18 |
| Last Update Date | 2008-08-11 |