| NPI | 1679951057 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN K LUZNICKY Program Director/Counselor 414-763-7751 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: WI 3091) |
| Enumeration Date | 2015-05-18 |
| Last Update Date | 2015-05-18 |