| NPI | 1851155048 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA L SUTHERS CEO 920-676-9697 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YM0800X Counselor, Mental Health | |
| 163WA0400X Registered Nurse, Addiction (Substance Use Disorder) | |
| 175T00000X Peer Specialist | |
| 251B00000X Case Management | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2024-02-08 |
| Last Update Date | 2024-03-01 |