| NPI | 1730947912 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA GEHRKE CEO 262-496-7456 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 251S00000X |
| 261QD1600X Clinic/Center, Developmental Disabilities | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2024-03-12 |
| Last Update Date | 2024-03-12 |