| NPI | 1639817836 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIA CECILIA S TAYLOR CFO 414-897-5407 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center Adolescent and Children Mental Health |
| Additional Taxonomies | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2022-05-26 |
| Last Update Date | 2022-05-26 |