| NPI | 1760881890 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BUCKLEY MEADE Director 414-427-4884 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: WI 17136-130) |
| Enumeration Date | 2014-08-14 |
| Last Update Date | 2014-08-14 |