| NPI | 1982728168 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTWAYNE M ROBERTSON Director Of Dhhs 262-548-7223 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: WI 10063326) |
| Enumeration Date | 2007-03-16 |
| Last Update Date | 2013-11-01 |