| NPI | 1144562273 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN DWAYNE GLOVER A.O.D.A Counselor 414-447-1965 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 16764-130) |
| Enumeration Date | 2013-03-27 |
| Last Update Date | 2013-03-27 |