| NPI | 1902214182 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAMELA TEGROTENHUIS Executive Director 920-459-8287 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: WI 410471) |
| Enumeration Date | 2014-07-31 |
| Last Update Date | 2014-07-31 |