| Kids In Transition | |
|
6314 N 104th St Milwaukee WI 53225-1408 | |
| (414) 688-3062 | |
| (414) 277-8916 |
| Full Name | Kids In Transition |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 6314 N 104th St, Milwaukee, Wisconsin |
| Authorized Official Name and Position | Cleon Edward Suggs (CLINICAL SUPERVISOR) |
| Authorized Official Contact | 4146883062 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kids In Transition 6314 N 104th St Milwaukee WI 53225-1408 Ph: (414) 688-3062 | Kids In Transition 6314 N 104th St Milwaukee WI 53225-1408 Ph: (414) 688-3062 |
| NPI Number | 1639317167 |
|---|---|
| Provider Enumeration Date | 01/21/2009 |
| Last Update Date | 01/21/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639317167 | NPI | - | NPPES |
| 39387800 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 10600132 (Wisconsin) | Secondary |
| 251S00000X | Community/behavioral Health | 11828134 (Wisconsin) | Primary |
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