| NPI | 1558589887 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHALONDA NICOLE BOOTH Registered Nurse 414-702-8339 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2020-08-22 |