| NPI | 1194233718 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAKIESHA RUSSELL President/Child & Family Therapist 414-395-0037 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: WI 6098-125) |
| Additional Taxonomies | 251S00000X (Licence: WI 6098-125) |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: WI 6098-125) | |
| Enumeration Date | 2018-01-17 |
| Last Update Date | 2018-01-17 |