| NPI | 1982654091 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOANN BERK Sr. Director Of Corporate Services 414-225-1568 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 251B00000X Case Management | |
| 261QD0000X Clinic/Center, Dental | |
| 261QH0100X Clinic/Center, Health Services | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2024-04-04 |