| NPI | 1760890636 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CYNTHIA VIAN Owner 414-213-9533 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: WI 4953-125) |
| Enumeration Date | 2014-07-23 |
| Last Update Date | 2014-07-23 |