| NPI | 1457789562 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREW FILIP SCOTT Business Manager 262-780-1780 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: OR 0222) |
| Enumeration Date | 2013-10-29 |
| Last Update Date | 2013-10-29 |