| NPI | 1972980217 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LATIKA N WASHINGTON Clinical Supervisor 414-967-7006 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2800X Clinic/Center, Methadone Clinic |
| Enumeration Date | 2015-05-06 |
| Last Update Date | 2015-05-06 |