| NPI | 1326745431 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE SIMMONS Owner 262-744-6638 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children |
| Enumeration Date | 2023-02-09 |
| Last Update Date | 2023-02-09 |