| NPI | 1922869312 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACY LEE KNOLL Owner 608-279-2481 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| Enumeration Date | 2024-01-22 |
| Last Update Date | 2025-09-26 |