Primrose Residential Facility
Clinic/Center, Community Health in Milwaukee, WI. Organization (NPI-2).
NPI number1003064064
StatusActive
Last updated in NPPESSep 3, 2008
Details
- NPI
- 1003064064
- Entity type
- Organization (NPI-2)
- Legal business name
- Primrose Residential Facility
- Organization subpart
- No
- Enumeration date
- Sep 3, 2008
- Last updated
- Sep 3, 2008
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QC1500X | Clinic/Center, Community Health | – | WI | Yes |
Other names
- Community Based Residential Facility (Doing Business As)
Practice location
3910 W Burleigh StMilwaukee, WI 53210-1816
Phone 414-445-3607 · Fax 414-445-6575
Mailing address
3910 W Burleigh StMilwaukee, WI 53210-1816
Phone 414-445-3607 · Fax 414-445-4575
Authorized official
Shirley Temple Gladney
Administrator
4144453607
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