| NPI | 1154479822 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NANCY MELNICK Regulatory Affairs Specialist 262-207-9362 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 302R00000X Health Maintenance Organization |
| Additional Taxonomies | 251T00000X PACE Provider Organization |
| 261QA0600X Clinic/Center, Adult Day Care | |
| Enumeration Date | 2007-01-08 |
| Last Update Date | 2021-12-15 |