| NPI | 1912228487 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHIL ROBINSON Clinical Supervisor 608-339-4505 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: WI 15906-130) |
| Enumeration Date | 2010-06-18 |
| Last Update Date | 2010-06-18 |