| NPI | 1619289782 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANDRE LASHAWN TURNER Office Manager 414-645-6665 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: WI 19077) |
| Enumeration Date | 2010-07-06 |
| Last Update Date | 2010-07-06 |