| NPI | 1730898362 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN PAUL BARTELME Senior Pastor/Counselor 414-400-8320 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center Adult Mental Health |
| Additional Taxonomies | 261QM0855X Clinic/Center Adolescent and Children Mental Health |
| Enumeration Date | 2022-11-22 |
| Last Update Date | 2022-11-22 |