| NPI | 1225472632 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRYSTAL A MCCLAIN Therapist 414-763-6603 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: WI 8035461) |
| Enumeration Date | 2013-04-29 |
| Last Update Date | 2013-04-29 |