NPI | 1114196854 |
---|---|
Entity Type | Organization |
Authorized Contact | GARY L ERDMANN Executive Director 262-965-2131 |
Organization Subpart ? | No |
Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: WI 265001) |
Additional Taxonomies | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: WI none) |
Enumeration Date | 2008-02-27 |
Last Update Date | 2008-02-27 |