| NPI | 1700574803 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICO SMITH Operations Manager 414-233-8860 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2023-04-26 |
| Last Update Date | 2023-04-26 |