| Wisconsin Independent Living Services Llc | |
|
2821 N 4th St Ste 516 Milwaukee WI 53212-2362 | |
| (414) 263-6000 | |
| (414) 332-2523 |
| Full Name | Wisconsin Independent Living Services Llc |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 2821 N 4th St, Milwaukee, Wisconsin |
| Authorized Official Name and Position | Shelia Sampton Fossie (PRESIDENT) |
| Authorized Official Contact | 4142636000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wisconsin Independent Living Services Llc 2821 N 4th St Ste 516 Milwaukee WI 53212-2362 Ph: (414) 263-6000 | Wisconsin Independent Living Services Llc 2821 N 4th St Ste 516 Milwaukee WI 53212-2362 Ph: (414) 263-6000 |
| NPI Number | 1477822534 |
|---|---|
| Provider Enumeration Date | 12/19/2011 |
| Last Update Date | 01/03/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477822534 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Primary |
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