| NPI | 1083252860 |
|---|---|
| Former Legal Business Name | TGL WELLNESS |
| Entity Type | Organization |
| Authorized Contact | TYLER LOOMIS Owner 414-218-6958 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2019-12-12 |
| Last Update Date | 2019-12-12 |