| NPI | 1972824571 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA FIELD Billing Specialist 608-834-1222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2010-06-17 |
| Last Update Date | 2024-07-29 |