| NPI | 1124559406 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY BAUMANN Associate Executive Director 262-524-4149 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2017-03-27 |
| Last Update Date | 2017-03-27 |