NPI | 1922604214 |
---|---|
Doing Business As | CRISTO REY SSCHC |
Entity Type | Organization |
Authorized Contact | MARIA CECILIA S TAYLOR CFO 414-897-5407 |
Organization Subpart ? | Yes |
Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
Additional Taxonomies | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Enumeration Date | 2020-12-10 |
Last Update Date | 2022-04-11 |