| NPI | 1790456184 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHIRNITA L KIRK President 262-339-4447 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251B00000X Case Management |
| Additional Taxonomies | 305R00000X Preferred Provider Organization |
| Enumeration Date | 2021-09-24 |
| Last Update Date | 2022-10-25 |