| NPI | 1568397883 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IDI USMAN President 262-271-1143 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2026-06-17 |
| Last Update Date | 2026-07-16 |