| NPI | 1841570447 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIM SLAMP Office Manager 920-632-7040 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center Adult Mental Health |
| Additional Taxonomies | 261QM0855X Clinic/Center Adolescent and Children Mental Health |
| Enumeration Date | 2011-08-26 |
| Last Update Date | 2011-08-26 |