| NPI | 1356618672 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CANDACE DAHLKE Owner 414-241-7067 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Additional Taxonomies | 320700000X Residential Treatment Facility, Physical Disabilities |
| Enumeration Date | 2011-12-01 |
| Last Update Date | 2011-12-01 |