| NPI | 1730224130 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES WALTER HOLIFIELD Owner 414-702-6130 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: WI 3086-123) |
| Enumeration Date | 2007-02-21 |
| Last Update Date | 2012-08-09 |