| NPI | 1083894992 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIA C SMITH Owner 414-426-5980 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 251E00000X Home Health |
| 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| Enumeration Date | 2007-11-08 |
| Last Update Date | 2012-06-20 |