| NPI | 1861840233 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CANDACE E COATES Therapist 414-810-2715 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: WI 8053) |
| Enumeration Date | 2016-05-26 |
| Last Update Date | 2016-05-26 |