| NPI | 1306029152 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAMONA DALANE WALKER RN Administrator 414-466-3372 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: WI 145791-030) |
| Enumeration Date | 2007-12-14 |
| Last Update Date | 2008-08-19 |