| NPI | 1144475765 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY RENARD OWENS CEO 414-234-1263 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: WI 2803) |
| Additional Taxonomies | 251S00000X (Licence: WI 2803) |
| 324500000X Substance Abuse Rehabilitation Facility (Licence: WI 2803) | |
| Enumeration Date | 2008-11-24 |
| Last Update Date | 2015-03-06 |