| NPI | 1477023729 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KARINA CHELSKY Administrator 414-467-8884 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 175T00000X Peer Specialist |
| 207Q00000X Family Medicine | |
| 261QR1100X Clinic/Center, Research | |
| Enumeration Date | 2018-11-29 |
| Last Update Date | 2022-05-25 |