| NPI | 1972148211 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD RAYMOND ZILLER President 262-375-2020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 225CA2500X Rehabilitation Counselor, Assistive Technology Supplier |
| 225CA2400X Rehabilitation Counselor, Assistive Technology Practitioner | |
| 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment | |
| Enumeration Date | 2019-11-11 |
| Last Update Date | 2019-11-11 |