| NPI | 1508586033 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHALONDA N MYLES Owner 414-702-8339 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2022-09-02 |
| Last Update Date | 2023-08-21 |