| NPI | 1164669719 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAUREL ANN PECKENPAUGH Director 262-573-4556 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2009-01-18 |
| Last Update Date | 2009-01-18 |