| NPI | 1518005818 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TITO IZARD President CEO 414-267-2021 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 261QC1500X Clinic/Center, Community Health |
| Enumeration Date | 2007-02-01 |
| Last Update Date | 2021-06-18 |