| NPI | 1366858292 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERRICKA BORDER Owner 262-880-5864 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: WI 128554121) |
| Enumeration Date | 2014-07-11 |
| Last Update Date | 2014-07-11 |