| NPI | 1376718320 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHERINE ANNA DIBB Substance Abuse Counselor 414-358-5381 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: WI 15361131) |
| Enumeration Date | 2008-04-29 |
| Last Update Date | 2008-04-29 |