| NPI | 1730440470 |
|---|---|
| Doing Business As | NONE |
| Entity Type | Organization |
| Authorized Contact | MAXIMO LIBRADA CUETO President 414-282-1152 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: WI 20379-20) |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health (Licence: WI 20379-20) |
| Enumeration Date | 2012-05-30 |
| Last Update Date | 2012-05-30 |