| NPI | 1528568102 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY L JACKSON Director 414-871-0350 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA0600X Clinic/Center, Adult Day Care (Licence: WI 0014754) |
| Enumeration Date | 2018-02-20 |
| Last Update Date | 2018-02-20 |