| NPI | 1184008583 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HERMAN LEWIS Director 262-784-8511 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2015-07-15 |
| Last Update Date | 2015-07-15 |