| NPI | 1629870712 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TEQUILLA MARIE DAWSON Owner 414-232-6268 |
| Organization Subpart ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 251K00000X Public Health or Welfare |
| 251S00000X Community/Behavioral Health | |
| 253Z00000X In Home Supportive Care | |
| 261QC1500X Clinic/Center, Community Health | |
| 261QF0050X Clinic/Center, Family Planning, Non-Surgical | |
| 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) | |
| 261QH0100X Clinic/Center, Health Services | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 261QP0904X Clinic/Center, Public Health, Federal | |
| 261QP0905X Clinic/Center, Public Health, State or Local | |
| 261QR0400X Clinic/Center, Rehabilitation | |
| 261QR0401X Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) | |
| 320800000X Community Based Residential Treatment Facility, Mental Illness | |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| Enumeration Date | 2025-03-27 |
| Last Update Date | 2026-08-08 |