NPI | 1932301306 |
---|---|
Entity Type | Organization |
Authorized Contact | PATRICK NORBERT BENNETT AO Da Administrator 715-362-5745 |
Organization Subpart ? | No |
Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
Enumeration Date | 2007-06-05 |
Last Update Date | 2020-08-22 |