| NPI | 1861037293 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVE PRINCE Business Manager 715-600-2798 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 101YP2500X Counselor, Professional | |
| 1041C0700X Social Worker, Clinical | |
| 106H00000X Marriage & Family Therapist | |
| 133V00000X Dietitian, Registered | |
| 207Q00000X Family Medicine | |
| 363L00000X Nurse Practitioner | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2019-11-08 |
| Last Update Date | 2023-02-02 |