| NPI | 1962839589 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALBERT L JACKSON CEO 414-301-1163 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2013-09-27 |
| Last Update Date | 2013-09-27 |