| NPI | 1497495840 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CATHERINE BUCHEGER Billing Director 262-490-7933 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children |
| Additional Taxonomies | 320600000X Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| 320900000X Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | |
| 323P00000X Psychiatric Residential Treatment Facility | |
| Enumeration Date | 2022-03-31 |
| Last Update Date | 2022-03-31 |