| NPI | 1700125622 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA JOY STALLMAN Registered Nurse 414-737-0280 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310500000X Intermediate Care Facility, Mental Illness (Licence: WI 168390-030) |
| Enumeration Date | 2013-02-13 |
| Last Update Date | 2013-02-13 |