| NPI | 1154514776 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFERY KINCAID Chief Executive Officer 414-546-6880 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: WI 2611) |
| Enumeration Date | 2007-08-27 |
| Last Update Date | 2007-08-27 |