| NPI | 1780016287 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YOLANDA RICHARDSON Program Director 414-324-4832 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: WI 16110-130) |
| Enumeration Date | 2013-08-07 |
| Last Update Date | 2013-08-07 |