| NPI | 1932733193 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROLYN JEAN BOYD-REED Administrator 414-839-6457 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| Enumeration Date | 2020-02-26 |
| Last Update Date | 2020-02-26 |