| NPI | 1649446238 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROSE KOHNKE Sr Administrator 414-445-9797 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: WI 2703) |
| Additional Taxonomies | 251V00000X Voluntary or Charitable (Licence: WI 2703) |
| Enumeration Date | 2008-05-02 |
| Last Update Date | 2008-05-02 |