| NPI | 1457527954 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLAN M. REYES President / Director 414-383-0755 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder (Licence: WI 2444) |
| Additional Taxonomies | 343900000X Non-emergency Medical Transport (VAN) (Licence: WI 41479300) |
| Enumeration Date | 2008-05-05 |
| Last Update Date | 2008-05-06 |