NPI | 1003389644 |
---|---|
Entity Type | Organization |
Authorized Contact | TRAVIS LANDRY Interim Director 414-239-9359 |
Organization Subpart ? | No |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
Enumeration Date | 2019-01-07 |
Last Update Date | 2019-01-07 |