Healthcare Provider Details

I. General information

NPI: 1851565485
Provider Name (Legal Business Name): ST. CHARLES YOUTH & FAMILY SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/15/2008
Last Update Date: 01/06/2026
Certification Date: 01/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

151 S 84TH ST
MILWAUKEE WI
53214-1456
US

IV. Provider business mailing address

151 S 84TH ST
MILWAUKEE WI
53214-1456
US

V. Phone/Fax

Practice location:
  • Phone: 414-476-3710
  • Fax: 414-778-5956
Mailing address:
  • Phone: 414-257-4300
  • Fax: 414-778-5946

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number15371-131
License Number StateWI

VIII. Authorized Official

Name: GREG KOST
Title or Position: CFO
Credential: CPA, MBA
Phone: 262-838-1191