| NPI | 1790411700 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRENA LOOMANS CEO 715-204-9433 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2022-08-01 |
| Last Update Date | 2024-07-18 |