| NPI | 1003489485 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEONIA PARKER Owner/Operator 414-595-4319 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251B00000X Case Management |
| Additional Taxonomies | 261QH0100X Clinic/Center, Health Services |
| Enumeration Date | 2021-07-22 |
| Last Update Date | 2021-09-24 |