| NPI | 1104019058 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAWN MARIE D'AMICO President 262-210-1952 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: WI 7252123) |
| Enumeration Date | 2007-08-23 |
| Last Update Date | 2008-11-14 |