| NPI | 1972886570 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARKETA JOHNSON Owner/Administrator 414-625-0037 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2011-09-21 |
| Last Update Date | 2011-09-21 |