| NPI | 1104591114 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JERRY M KAHN Lcsw 414-803-7238 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2021-08-11 |
| Last Update Date | 2021-11-01 |