| NPI | 1982821930 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NAN NELSON Treasurer 414-299-1610 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 283Q00000X Psychiatric Hospital | |
| Enumeration Date | 2007-04-19 |
| Last Update Date | 2018-06-11 |