| NPI | 1780240614 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH J NELAN Owner/Provider 414-433-9193 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2019-05-16 |
| Last Update Date | 2019-05-16 |