| NPI | 1962147363 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIET PELLICANE Clinician 414-465-2585 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2022-04-29 |
| Last Update Date | 2022-04-29 |