| NPI | 1104649144 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TYNISHA MCWRIGHT Owner 414-897-3457 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2024-11-07 |
| Last Update Date | 2024-11-07 |