| NPI | 1275289647 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAUREEN PAYNE Administrator 414-526-1743 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD1600X Clinic/Center, Developmental Disabilities |
| Enumeration Date | 2022-02-24 |
| Last Update Date | 2022-02-24 |