| NPI | 1649090168 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEORGE WEAVER COO 414-309-2740 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2024-10-10 |
| Last Update Date | 2024-10-10 |