NPI | 1114521515 |
---|---|
Entity Type | Organization |
Authorized Contact | TAMARA FRITSCH Credentialing And Billing Manager 414-793-4277 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
Enumeration Date | 2020-11-25 |
Last Update Date | 2021-05-07 |