| NPI | 1003055047 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL BRAXTON Program Director 414-324-5318 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: WI 15388-130) |
| Enumeration Date | 2009-02-16 |
| Last Update Date | 2009-02-22 |