NPI | 1588909923 |
---|---|
Entity Type | Organization |
Authorized Contact | THOMAS G MLODZIK CEO 414-324-9332 |
Organization Subpart ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149012902) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IL 27402) |
106H00000X Marriage & Family Therapist (Licence: IL 166000729) | |
Enumeration Date | 2012-12-11 |
Last Update Date | 2023-08-18 |