| NPI | 1831851799 |
|---|---|
| Other Name | AMS OF WISCONSIN-MINOCQUA |
| Entity Type | Organization |
| Authorized Contact | GEORGE MICHAEL ERRICO President 727-301-3070 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM2800X Clinic/Center, Methadone Clinic |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2021-10-08 |
| Last Update Date | 2021-10-08 |