| NPI | 1528344819 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK B SMUCKLER President 414-332-2450 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: WI 16139) |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: WI 16139) |
| Enumeration Date | 2011-10-31 |
| Last Update Date | 2011-10-31 |