| NPI | 1932817921 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY HOLDER Owner 608-616-5018 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 261QM0801X |
| Enumeration Date | 2022-11-09 |
| Last Update Date | 2023-04-17 |