| NPI | 1821248048 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES LOUIS PAQUETTE Director Owner 262-255-4178 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) (Licence: WI 1031) |
| Enumeration Date | 2008-09-24 |
| Last Update Date | 2008-09-24 |