| NPI | 1346579653 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STARLETTE MARIE PATTERSON Clinic Administrator 414-435-1115 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2009-12-15 |
| Last Update Date | 2023-02-21 |