| NPI | 1902501208 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PETER BRUNZELLE President/Owner 262-420-9088 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2023-04-04 |
| Last Update Date | 2023-04-04 |