Provider First Line Business Practice Location Address:
1212 S 70 ST
Provider Second Line Business Practice Location Address:
LACAUSA TREATMENT SERVICES
Provider Business Practice Location Address City Name:
MILWAUKEE
Provider Business Practice Location Address State Name:
WI
Provider Business Practice Location Address Postal Code:
53214-1924
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
414-902-1500
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/07/2007