NPI | 1578755237 |
---|---|
Entity Type | Organization |
Authorized Contact | MARY HELEN LILLICH Owner 262-375-8441 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
Enumeration Date | 2007-08-15 |
Last Update Date | 2008-01-30 |