| NPI | 1649364365 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTHONY WILBERT CARR Addiction Therapist 414-384-2000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: WI 320800000X) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2020-08-22 |