| NPI | 1306095823 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY ZIEMER NERVIG Owner 414-258-5523 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: WI 475-123) |
| Enumeration Date | 2008-09-09 |
| Last Update Date | 2008-09-09 |