| NPI | 1104367804 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LATOYIA GIBSON Owner / Operator 414-467-9927 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| 251B00000X Case Management | |
| Enumeration Date | 2017-03-14 |
| Last Update Date | 2017-11-14 |