| Easter Seals Southeast Wisconsin | |
|
3090 N 53rd St Milwaukee WI 53210-1617 | |
| (414) 449-4444 | |
| Not Available |
| Full Name | Easter Seals Southeast Wisconsin |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 3090 N 53rd St, Milwaukee, Wisconsin |
| Authorized Official Name and Position | Kimberly Jurowski (BEHAVIOR ANALYST) |
| Authorized Official Contact | 2625815394 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Easter Seals Southeast Wisconsin 3090 N 53rd St Milwaukee WI 53210-1617 Ph: (414) 449-4444 | Easter Seals Southeast Wisconsin 3090 N 53rd St Milwaukee WI 53210-1617 Ph: (414) 449-4444 |
| NPI Number | 1396037511 |
|---|---|
| Provider Enumeration Date | 05/05/2011 |
| Last Update Date | 05/05/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396037511 | NPI | - | NPPES |
| 41209100 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | BCBA 103K00000X (Wisconsin) | Primary |
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