| NPI | 1679981328 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KARINA CHELSKY Practice Manager 414-467-8884 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| 324500000X Substance Abuse Rehabilitation Facility (Licence: WI 3045) | |
| Enumeration Date | 2014-07-25 |
| Last Update Date | 2018-06-16 |