| NPI | 1205225919 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS E MARTIN Controller 414-256-4812 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: WI 2746) |
| Enumeration Date | 2015-01-19 |
| Last Update Date | 2015-01-19 |