| NPI | 1972919314 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT J LUEGER Licensed Psychologist 414-403-1481 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: WI 984-57) |
| Additional Taxonomies | 305R00000X Preferred Provider Organization (Licence: WI 984-57) |
| Enumeration Date | 2014-07-07 |
| Last Update Date | 2014-07-07 |