| NPI | 1003928391 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRAIG ALLAN MODELL Owner 414-962-9156 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2009-02-11 |