| NPI | 1942637962 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BERT BERGER Mental Health Divison Manager 414-384-2000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QV0200X Clinic/Center, VA (Licence: WI 3117-57) |
| Enumeration Date | 2013-10-04 |
| Last Update Date | 2013-10-04 |