| NPI | 1851565485 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREG KOST CFO 262-838-1191 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: WI 15371-131) |
| Enumeration Date | 2008-04-15 |
| Last Update Date | 2025-07-24 |