| NPI | 1740589084 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES G WHITE Executive Director 414-264-7822 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: WI 2024) |
| Enumeration Date | 2011-03-25 |
| Last Update Date | 2011-03-25 |