| NPI | 1811776727 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CINDY MEYER President & CEO 262-303-0580 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X |
| Additional Taxonomies | 261QM0801X |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2023-09-28 |
| Last Update Date | 2024-02-21 |