Healthcare Provider Details

I. General information

NPI: 1851728893
Provider Name (Legal Business Name): FACE2FACE COMMUNITY SERVICE & TRAINING CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2013
Last Update Date: 10/06/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3220 N 35TH ST
MILWAUKEE WI
53216-3708
US

IV. Provider business mailing address

3220 N 35TH ST
MILWAUKEE WI
53216-3708
US

V. Phone/Fax

Practice location:
  • Phone: 414-364-3905
  • Fax: 847-770-4497
Mailing address:
  • Phone: 414-364-3905
  • Fax: 847-770-4497

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: GWEN SANIFORD
Title or Position: MANAGER
Credential:
Phone: 414-364-3905