| NPI | 1174265854 |
|---|---|
| Other Name | LINCOLN AVENUE SCHOOL |
| Entity Type | Organization |
| Authorized Contact | MARIA CECILIA S TAYLOR CFO 414-897-5407 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Additional Taxonomies | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2022-04-12 |
| Last Update Date | 2022-04-12 |