NPI | 1811104995 |
---|---|
Entity Type | Organization |
Authorized Contact | CHARLES JOHN ENGEL President 262-549-6600 |
Organization Subpart ? | No |
Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: WI 1748) |
Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility (Licence: WI 1747) |
Enumeration Date | 2007-05-17 |
Last Update Date | 2020-08-22 |