| NPI | 1306070032 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON ANDREW PECKELS President 414-801-7905 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: IL 060010196) |
| Enumeration Date | 2009-05-09 |
| Last Update Date | 2009-05-09 |