| NPI | 1770916645 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HENRY EDWARD TYLER Executive Director 414-745-0925 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: WI L052978) |
| Enumeration Date | 2013-08-15 |
| Last Update Date | 2013-08-15 |