| NPI | 1629652433 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NIKQUAN LEWIS Psychotherapist 262-271-7591 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2021-05-07 |
| Last Update Date | 2021-05-07 |