| NPI | 1710306949 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHUCK HOLLOWAY Executive Director 414-449-9908 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 2634) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WI 2634) |
| Enumeration Date | 2014-04-15 |
| Last Update Date | 2014-04-15 |