| NPI | 1821312059 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHLEEN BRODERICK WOODY Clinic Director 414-256-0077 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: WI 2041-057) |
| Enumeration Date | 2010-03-17 |
| Last Update Date | 2010-03-17 |