| NPI | 1003375049 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IESHA SANDERS Owner 414-841-5648 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2019-03-19 |
| Last Update Date | 2019-03-19 |