| NPI | 1790113207 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BETTY RYGIEWICZ Clinic Director 608-663-4364 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: WI 951124) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: WI 1155-226) |
| Enumeration Date | 2013-10-18 |
| Last Update Date | 2013-10-18 |