| NPI | 1639244254 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CONSTANCE A SHAVER Executive Director 414-342-3237 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2006-11-21 |
| Last Update Date | 2020-08-22 |