| NPI | 1285157529 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IGONI IGONI Co Owner 414-763-2072 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD1600X Clinic/Center, Developmental Disabilities (Licence: WI 0015719) |
| Enumeration Date | 2017-07-19 |
| Last Update Date | 2022-07-21 |