| NPI | 1497093520 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICIA LOUISE GRAY Substance Abuse Counselor 414-447-1965 |
| Organization Subpart ? | No |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency (Licence: WI 15653-130) |
| Enumeration Date | 2013-01-24 |
| Last Update Date | 2013-01-24 |