| NPI | 1790180677 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESS MCCANN Healthcare Account Manager 414-395-4485 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320700000X Residential Treatment Facility, Physical Disabilities (Licence: MO 2014007209) |
| Enumeration Date | 2014-11-04 |
| Last Update Date | 2014-11-04 |