Healthcare Provider Details

I. General information

NPI: 1508776329
Provider Name (Legal Business Name): THE MISSING PEACE COMMUNITY COLLECTIVE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/11/2026
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3248 W BROWN ST
MILWAUKEE WI
53208-1950
US

IV. Provider business mailing address

3248 W BROWN ST
MILWAUKEE WI
53208-1950
US

V. Phone/Fax

Practice location:
  • Phone: 414-269-2111
  • Fax:
Mailing address:
  • Phone: 414-269-2111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: NATALIA A RENTERIA
Title or Position: OWNER
Credential:
Phone: 414-269-2111