| NPI | 1134764103 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSIE K ANDERS Officer 414-899-9897 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children |
| Enumeration Date | 2019-11-13 |
| Last Update Date | 2019-11-13 |