| NPI | 1962678466 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LASHAWNDA DAVIS Director 414-616-8805 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: WI 2491) |
| Enumeration Date | 2008-05-05 |
| Last Update Date | 2008-05-05 |