| NPI | 1518783497 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUREAN NELSON President 414-550-8098 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2024-11-25 |
| Last Update Date | 2024-11-25 |