Healthcare Provider Details

I. General information

NPI: 1063119584
Provider Name (Legal Business Name): EUPHORIC FAMILY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/15/2023
Last Update Date: 09/08/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11110 W CARMEN AVE
MILWAUKEE WI
53225-3502
US

IV. Provider business mailing address

5260 N 84TH ST
MILWAUKEE WI
53225-3502
US

V. Phone/Fax

Practice location:
  • Phone: 414-436-9296
  • Fax:
Mailing address:
  • Phone: 414-999-9999
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code156F00000X
TaxonomyTechnician/Technologist
License Number
License Number StateNULL

VIII. Authorized Official

Name: LATOYA M SMITH
Title or Position: OWNER
Credential:
Phone: 414-436-9296