| NPI | 1821740457 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELINA HOWARD Owner/Operator 414-839-8721 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2022-01-25 |
| Last Update Date | 2022-01-25 |