| NPI | 1528330198 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TOM PUCCIO Staffer 414-615-0665 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320700000X Residential Treatment Facility, Physical Disabilities (Licence: WI 1393-019) |
| Enumeration Date | 2012-01-29 |
| Last Update Date | 2012-01-29 |