| NPI | 1447657739 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYLE A IGNACE Executive Director 414-383-9526 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: WI 3040) |
| Enumeration Date | 2014-12-02 |
| Last Update Date | 2024-12-05 |