| NPI | 1982212551 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANNON JAMES Owner 414-336-0525 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2020-07-20 |
| Last Update Date | 2020-07-20 |