| NPI | 1831053008 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIFFANY SANCHEZ Program & Operations Analyst 414-858-4141 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2025-12-12 |
| Last Update Date | 2025-12-12 |