| NPI | 1003930223 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID M DEROSIER Credentialing Specialist 262-548-8431 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251B00000X Case Management (Licence: WI 43077000) |
| Enumeration Date | 2007-03-16 |
| Last Update Date | 2023-09-27 |