| NPI | 1902099344 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIANNE YOPPS Executive Assistant 414-930-4421 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2007-08-20 |
| Last Update Date | 2021-04-28 |