| NPI | 1336296722 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAM KWANG SOO President 414-964-6077 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: WI 19331) |
| Enumeration Date | 2007-01-05 |
| Last Update Date | 2020-08-22 |