| Career Youth Development | |
|
2601 N Martin Luther King Dr Milwaukee WI 53212-2711 | |
| (414) 263-8352 | |
| Not Available |
| Full Name | Career Youth Development |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 2601 N Martin Luther King Dr, Milwaukee, Wisconsin |
| Authorized Official Name and Position | Sterlon White (AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 4142638352 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Career Youth Development 6400 Industrial Loop Greendale WI 53129-2452 Ph: (414) 423-4100 | Career Youth Development 2601 N Martin Luther King Dr Milwaukee WI 53212-2711 Ph: (414) 263-8352 |
| NPI Number | 1215195623 |
|---|---|
| Provider Enumeration Date | 06/02/2008 |
| Last Update Date | 06/02/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215195623 | NPI | - | NPPES |
| 42170400 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (Wisconsin) | Primary |
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