| NPI | 1023351947 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GERALD E. SULLIVAN Medical Director 414-447-9890 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 10600132) |
| Enumeration Date | 2013-03-28 |
| Last Update Date | 2013-03-28 |