| NPI | 1760408876 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DARREN MATAVKA Vice President 414-301-6383 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 1041C0700X Social Worker, Clinical | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2013-09-30 |